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David Marc Buckner 2023 Annual Lobbyist Registration Form MIAMI BEACH RECEIVED APR .25 2023 City of Miami Beach 1700 Convention Center Drive CITY OF MIAMI BEACH Miami Beach, Florida 33139 OFFICE OF THE CITY CLERK www.miamibeachfl.gov City Clerk's Office Tel: 305-673-7411 Fax: 305-673-7254 Office Use Only ANNUAL LOBBYIST REGISTRATION FORM David Marc Buckner Name: Business Name: Buckner and Miles, PA Address: 2020 Salzedo Street Suite 302, Coral Gables, FL 33134 Office Telephone Number: 305-964-8003 Cellular Telephone Number: 786 303 3447 david@bucknermiles.com Email Address: If more than one lobbyist,please list: 1) 2) 3) 4) 5) 6) 7) Submit this form to the Office of the City Clerk, along with a check for $500 for each lobbyist.Please make the check(s) payable to the City of Miami Beach. /� // For City Clerk's Office Use Only MCR#:73551 Amount paid: jg S CYo Date paid: Processed by ' NQ'4"9VGZ Date: F:ICLER\SALL1aFORMS\LOBBYIST FORMS ANNUAL LOBBYIST REGISTRATION FORM reg.docx 1 o MBF �, . s .. City Hall r' r-:> r 1700 Convention Center Dr. '" Miami Beach , FL 33139 °7 X 305-673-7420 r U s N y C Welcome 'm - as •�_ V` 04/25/2023 11 ;52AM Carmen V. t` " { Via: z p :: MISCELLANEOUS { Reference 1: MCR431559 8 MCR OPEN (NCR) � " m.. - j I 2023 Item; MCR ; 1 @ $500.0000 d ;�` NCR OPEN (MCR) $500:00 `.. $500.00 •} 'I' Subtotal $500.00 j Total $500.00 $ ` CHECK $500,00 :' :: 4,, , , -ILI f-\r . -1—<€1).) :1 W Check Number501552 N N „11Change due $0.00 6 I Paid by; BUCKNER AND MILES P.A. V .. 0 �.., ,.,, M Q 2 o ' IIiIIIIIIIIII1111IIIIIIIIIIIIIIilllilllllllllllllllllllllllIII > O _N :� i; w -.00 a ; F' O s Q '...-..__�F 'e,,jj,,m ^" mn a.� ._......_.-....— &man cLFLihCf malt ej1Y°i,. H ~ V � � Il.. V •�' Q3 = 6v7 L '' ''' • LIAS • Tsdom ° .5 r N. m `N).'5' U '5, ~ Q a, - r','. 1 " PIYJNIJNDAiu&OWIOa 001lMY{ t m ' •, ro Y . ~I .f Thank you for your payment CUSTOMER COPY •