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Angel Pallin 2022 Fee Expenditure and Compensation Form • City of Miami Beach Lobbyist Fee Expenditure and Compensation Statement RE.0 . .D City Code Section 2-485 MAR —3 2022 Crry Expenditure report for the period of: 01/01/2021 through 12/31/2021 OFF E O��/'4 BFgC ti A statement shall be filed even if there have been no expenditures or compensation during the reporting per o.CLERK 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 citvclerk@miamibeachfl.gov. -Lobbyist Angel Pallin Principal Mount Sinai Medical Center Issue Seawall and Flood Mitigation PLEASE COMPLETE THE SECTION BELOW • Detail Compensation Received: 0 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0 Communication: 0 Media Advertising: 0 Publications: 0 Travel: 0 Lodging: 0 Special Events: 0 CHECK BOX IF YOU NO LONGER REPRESENT THE PRINCIPAL FOR THE ABOVE ISSUE V DATE REPRESENTATION ENDED: 12/30/21 OATH State of Florida, County of Miami-Dade I,the undersigned lobbyist do hereby depose under oath and affirm that the information disclos he in an n tt ment hereto are true and correct. b ist ignatur SIGNATURE AND STAMP OF NOTARY: iN1YP.'••VI PAULINE LOPEZ • Notary Public-State of Florida Commission#HH 132456 Produced IDogF!° My Comm.Expires May 30,2025 Bonded through National Not Assn. Form of IdentificationSignature of Public Notary—State o lorida Personally known Sworn to and subscribed before me This -3 day of Q 202.) F:\CLE t\$ALL`:•aFORMS\LOBBYIST FORMS\ChvlB LFEaC.S.doc Rev.01.104{/16 OdIPO