Annual Lobbyist Registration Form MIAMI BEACH RECE VED
Nov 09 2023
City of Miami Beach
1700 Convention Center Drive
Miami Beach, Florida 33139
OFF4CE OF THE CI
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www.miamibeachfl.gov
City Clerk's Office
Tel: 305-673-7411
Fax: 305-673-7254 Office Use Only
ANNUAL LOBBYIST REGISTRATION FORM
Name: 416 nrre, /ercS
Bus ness Name: Pe1ei'/ /Z'e $ f r/ L2J i J/-7C•
Address: Z S Z,S 5 z-' Z 7 ._4tre /7 S / d 5-/0o✓ /-#7/4,,,/, IZ 35/33
Office Telephone Number: 3or 5-662- S3 /q
Cellular Telephone Number: 3of— . SZ-- �f /99
Email Address: ? Ct rrr� / ' Fe-(e/,r4. yes • (e
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 #:q3 D5 4/6
Amount paid: � Date paid: 1/ — 9 —
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