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Sheila Small 2022 Lobbyist Fee Expenditure and Compensation Form RECEIVED City of Miami Beach Lobbyist Fee Expenditure and Compensation Statement APR 29 2022 City Code Section 2-485 CITY OF MIAIVII gEACH OFFICE OF THE CITY CLERK Expenditure report for the period of: 1/1/2021 through 12/31/2021 A statement shall be filed even if there have been no expenditures or compensation during the reporting period. This statement is to be signed, notarized and returned to the City of Miami Beach,City Clerk's Office, 1700 Convention Center Drive, Miami Beach, FL 33139 by February 28th.A fine of$50.00 per day, per issue,shall be assessed for statements filed after the due date. If you require any assistance, please contact this office at 305.673.7411 or at cityclerkPmiamibeach.gov. Lobbyist Sheila Small Principal Live Nation Worldwide, Inc. Issue Filmore Theater Operating Agreement PLEASE COMPLETE THE SECTION BELOW Detail Compensation Received: CATEGORIES OF EXPENDITURES Food and Beverage: -0- Entertainment: -0- Research: -0- Communication: -0- Media Advertising: -0- Publications: -0- Travel: -0- Lodging: -0- Special Events: -0- CHECK BOX IF YOU NO LONGER REPRESENT THE PRINCIPAL FOR THE ABOVE ISSUE DATE REPRESENTATION ENDED: OATH State of Florida, County of Miami-Dade I,the undersigned lobbyist do hereby depose under oath and affirm that the information disclosed herein and any attachment hereto are true and correct. mS"I\IVQ40 Lobbyist Signature SIGNATURE AND STAMP OF-NOTARY: ( . ,, ZZ Produced ID Form of Identification Signature of Public Notary—State of Florida _Personally known Sworn to and subscribed before me This day of ,20 F:\CLER\SALL\aFORMS\LOBBYIST FORMS\CMB LFEaCS.pdf Rev,01/04/16 /liafRy /1 ITAc CALIFORNIA JURAT A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document,to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document. STATE OF CALIFORNIA } COUNTY OF A N,,-. E L r } Subscribed and sworn to (or affirmed) before me on this ` day of t / L , a 0 a oZ Date Month Year by ,C E l I- _ /1 4 L Name of Signers proved to me on the basis of satisfactory evidence to be the person(s) who appeared before me. /�/J 1\ Notary Public California Signature: t( / i kty• Los Angeles County s Cornmisslon p 2394401 Signatu�e of No ary Public - My Comm-Expire%Mar 4,2026 Seal Place Notary Seal Above OPTIONAL Though this section is optional, completing this information can deter alteration of the document or fraudulent attachment of this form to an unintended document. Description of Attached Document _ Title or Type of Document: G A, /' 1 S 1 X r E ti,() / r �( � l ( (/ tirzA/J4,77 /1, Document Date: II s /4 rz/i/EtiT Number of Pages: ( t cL - / -- Signer(s)Other Than Named Above: