Louis St. Clair
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Miami B""",,
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City of Miami Beach Office of the City Clerk
1700 Convention Center Drive, Miami Beach, FL 33139
LOBBYIST REGISTRATION FORM
Lobbyist means all persons employed or retained, whether paid or not, by a prindpal who seeks to encourage the passage, defeat
or modification of any ordinance, resolution, action or decision of any commissioner; any action, decision, recommendation of the
City Manager or any city board or committee; or any action, decision or recommendation of any dty personnel defined in any
manner in this section, during the time period of the entire decision-making process on such action, decision or recommendation
that foreseeably will be heard or reviewed by the city commission, or a city board or committee. The term specifically includes the
prindpal as well as any employee engaged in lobbying activities. 11Ie term -lobbyists- hu .,ecIf1c exclusions. Plea.. re'er
to Ordhance 200+343S.
Sf. cJAliL.
(Last)
So B/li
(Number and Street)
Lov,s
(First)
(M.I)
.
IA I
(State) (Zip Code)
b!d"IA~l4uMi. -""1
EMAIL: ,
~o5". 372. ./g,.,_
TELEPHONE NUMBER:
(Oty)
3u$.312.//75
FAX NUMBER:
L LOllYI5r RETAINED IV:
,tJn.lp e,"L aDII'ltNfJII... LLt!.
NAME OF PRINCIPAl/C~NT: ':1 r
4tt. *5iKJ III' #III; rt. 331.
( mber and Street) (City) (State) (Zip Code)
~~. ~ 12 . >/~2 3-$. '72 . S /11
TELEPHONE NUMBER: FAX NUMBER: (Optional) EMAIL: (Optional)
Fill out this ..ctIon If prlndpalls a Corporation, Partnenhlp or Trust [Sectltll82 (c)]
NAME OF CHIEF OFFICER, PARTNER, OR BENEFICIARY: I/II'SSItI,.,J4. fflf.ltRlf;
IDENTIFY ALL PERSONS HOLDING, DIRECTLY OR INDIRECfLY, A S% OR MORE OWNERSHIP INTEREST IN SUCH
CORPORATION, PARTNERSHIP OR TRUST: 1/ 1l'.ssJf~ H4iU!f~ . -- . . /t ,. .
o TI, '~""Ml' Z'~ 'IN"," tll'
II. SPECIFIC LOIIV ISSUE:
Issue to bee~::Q *etail):
III. CITY AGENCIES/INDMDUALS TO IE IDlED:
A} Full Name 0' Individual/Title
I} Any Financial, Familial or Profuslon"latlonshlp
P"(J('''4 f,.,.. B04
~\'(J ~ +
IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WHETHDIRLY,
FLAT RATE OR OTHER) :
,
N"...,F
A) LOBBYIST DISCLOSURE: (R..ulred)
B) PRINCIPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION): (Requlre4. A/ II Nr
Yes'~ = ~~~ reDresentlnG a nofor-Droflt col'DOratl. or entity without sDeclal comDensatlOll"o
_bu_I!.'I___. Pursuant to Ordinance No. 20043435-
Pursuant to Ordinance No.2003-3393 Amendinc Miami Beach CitY Code Chaoter 2. Article VII. Division 5
Thereof Entitled "Camoaign Finance Reform" Via The Addition Of Code Section 2-488 Entitled "Prohibited
Camoaicn Contributions Bv Lobbvists On Procurement Issues":
1)
Yes rG
2)
Yes ~
V.
Are YOU lobbYinG on a Dresent or DendlnG bid for GOods, eGulDment or services. or on a Dresent
or DendlnG award for Goods. eGulDmenlr service?
Pursuant to Ordinance No 2003-3395 Amendinc Miami Beach City Code Chaoter 2. Article VII Division 5
thereof Entitled "Camoaicn Finance Reform". Via The Addition Of Code Section 2-490 Entitled "Prohibited
Camoaicn Contributions Bv Lobbvists On Real Estate Develooment Issues":
Are YOU lobbyinG on a DendlnG aDDllcatlon for a DeyeloDment AGreement with the City or
aDDllcatlon for chanGe of zoninG maD desiGnation or chanGe to the City's Future Land Use Map?
SIGNATURE UNDER OKH:
ON OCTOBER ff OF EACH YEAR, EACH LOBBYIST SHALL SUBMIT TO THE CITY CLERK A SIGNED
STATEMENT UNDER OATH, USTlNG LOBBYING EXPENDITUI\EU WELL AS COMPENSATION
RECEIVED, IN THE CITY OF MIAMI BEACH FOR THE PRECE NG AR YEAJa STATEMENT
SHALL BE FILED EVEN IF THERBiAVE BEEN NO EXP IITU S ENSA11tN DURING THE
REPORTING PERIOD.
,.
LOBBYIST IDENTIFICATION:
I do solemnly swear that all of the foregoing facts are true and correct an
familiar with the provisions contained in Section 2-482 of the . mi Be
requirements.
Signature of Lobbyist:
Signature of Principal/Client:
VI.
,
PRlNCIPALmENTlFICATlON:
Produced ID
Produced ID ______
~ Form of Identification
Form of Identification
Personally known (Lobbyist)
----
Personally known (D.'-;lp.I)
VII. SIGNATURE AND STAMP OF NOTARY:
Signature of Public Notary - State of Florida
Notarization of Lobbyist's slgnllte
;'; ~ 08rnIHl& ..-
*JI* Mv eommlaion CC8lllIll14
'i:.:'/ Expires September 10, 2004
State of Florida, County of Miami-Dade
Sworn to aP4 subscribe b me 5"'. ~ I
This ~" J day of 1..- 2U'.:::::'~
Signature 0 Public Notary - State Florid
Notarization of Principal's signatu
#~'~ MOHIEDDIAN D. ZARIF
.: MY COMMISSION 11 DD~
~1If"" EXPIRES: F.b'UlI)~.2OOII
-j.//.ot/
FOR CLERK'
Annual Registration fee: [ <--rYes [ ] No Amount Pai
Lobbyist Registration Form received and verified by:
Revised 02/10/04 F: CLER