2024 Lobbyist Registration Form - 34 Star Island DRB23-0983 (Anthony Hsieh) .� Sl�c'�5)aar�
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Office of the City Clerk
1700 Convention Center Drive ��T� U� !'�,ilr";MI$Ep,�H
MiamiBeach, FL33139 ���CE!'�� -:a'`r�T�'r�ERK
305.673.7411 �R� 7 _��,�
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LOBBYIST REGISTRATION FORM
Lobbyist means all persons employed or retained, whether paitl or not, by a pnncipal who ueks to encourage the passage, tlefeat w
motlificalion of any oMinance, resoNtion, action or dedsion of any commissiorrer; any action, decision, remmmendatlon of ihe City
Managef of any City board or committee;or any actioq tleGslon of recommentlation of any Ciry pereonnel tluring the time De�od of the
enlire Aecision-making pracess on such ac[ion, decision or recommendation that foreseeably will be heard or reviewetl by ihe Ciry
Commission, or a City boartl or committee. The term specifically includes the pnncipal as well as any employee engagetl in lobbying
activities. The[ertn "Lobbyist" has specific exclusions. Please refer to City Code Chapter 2, Article VII, Division 3, entitled "Lobbyists,'
for atlditional infofmatiort �
InaVuctions: Please compkte all sections of Mis fortn and submit Me completed form, with the applicable�ee,ro the Office of t�e Ctty
Clerk. If you rreed more sDace[o canplHe an answer, uu a separate sheet(s)of paper. It you have nothing to report in a particular
sectioq you must wnte "none" or "n!a' in that section. Any change to any information onginalty filed, or any additional City
Commissioner or personnel who are also sought to be lobbied shall require tha�the lobbyisl file an amentlment to Ne registration form. .
The lobbyist has a continuing duty ta suppry infortnation and amentl the fortns fled throughout Ne period that the lobbying occure.
Separate registration forms shall be reQuiretl for each pnncipal represented on each specific issue.
I. LOBBYIST INFORMATION:
Hevia Wesley
NAME Of LOBBYIST (LasQ (First) (Mitltlle Name)
LSN Law, P.A. 3800 NE 'Ist Avenue Suite 200 Miami FI 33137
LOBBYISTBUSWESSNhMEANDAODRESS (NumberandSVeM) (Ciy) (Slate) (2ipCode)
305-6732528 whevia@Isnlaw.com
IOBBYIST BUSINESS TELEPHONE NUMBER CELLULAR TELEPHONE NUMBER EMNIL ADDRESS
11. PRINCIPAL INFORMATION:
Hsieh Anthony
NAMEOiPRMQPAL (Last) (First) (MiatlleName)
JLSA Star LLC 34 Star Island Drive Miami Beach FL 33139
PRINCIPA�BUSWESSNAMEANDADDRESS (NumberandS�ree�) (Ciy) (State) (ZipCotle)
617-710-7023 mauricegriotllc@gmail.com
PRINCIPALBUSWESSTELEPHONENUMBER CELWLARTELEPHONENUMBER EMAILA�ORESS
PuesuaM ta City Cotle Sedion 2-/82(li)I�)Ia): A pnndpal ot a�ry caporatlon, pehnaralip, ar oMer entlry who eOGaem as a IaEbyia[on be�aH of ihal
erroy,wHFrout epedal wmpenaetion or reimbursemeM for ihe eppeerance,whether tlirect,intlire�l,or conti�gmt,lo exqess suppM oF or appmition to
an item s�all iegis�er v.iN�Ire Clerk as requiretl by pea aubsed'pn but shall rwl be requiretl to pey aly regisVa�pn fees.
If the principal is a Corporation, Partnership or Trust, the following informatlon MUST be provided
pursuant to City Code Section 2482(c):
• NAME OF CHIEF OFFICER,PARTNER,OR BENEFICIARY(i(none,write WA�: An}hOfly H51@h (SOIe MembB�)
• NAME OF qLL PERSONS HOLDING,DIRECTLY OR INDIRECTIY,A 5%OR MORE OWNERSHIP INTEREST IN SUCH
CORPORATION,PARTNERSHIP OR TRUST(if none,write N/A): Aflthony H510h (SOIB MEfltbBf)
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III. ISSUE TO BE LOBBIED:
Describe wkh as much detail as is prectical, including but not limited to a.spec'rfic description where
applicable of a pending request for proposal, invitation to bid, or public hearing number.
Development approvals& permitting issues, including, but not limited to Members of the City Administration,
Members of Ciry Staff and Members of HPB, PB, DRB, and BOA, Ciry Commiuion and Mayor, relating to
The property located at 34 Star Island Dnve, file number DR823-0983.
IV. CITY AGENCIES/INDIVIDUALS TO BE LOBBIED:
Pursuant to City Code Section 2-482�a)(4), list the City Commissioner or City personnel sought to be
lobbied, and whether the lobbyist has entered into any contractual relationship (paid or unpaid) with
sald City Commissioner or City personnel from 72 months preceding such commencement of service
with the City to the present date,stating the generel nature of the subject contractual relationship.
Full Name of Individual and Controctual Relationship(If yes,explain) YES NO
Title ot Person to be Lobbied
Members of Ciiy Administration and Members of Ci Staff X
Members of Historic Preservation Board (HPB) X
Planning Board (PB), Design Review Board (DRB) X
Board of Adjustment (BOA), City Commission and ayor X
Pursuant to City Code Section 2�82(g), every registrent shall be required to state the extent of any
business, financial, familial or professional relationship, or other relationship giving rise to an
appearence of an impropriety, with any current City Commissioner or City personnel who is sought to
be lobbied as identified on the lobbyist registretion form filed.
List any Business, Financial, Familial or Professional Relationahip, or other relationship giving rise to an
a eannce of im ro ri if none,wrile N/A :
N/A
V. DISCLOSE RATE AND AMOUNT OF LOBBYIST COMPENSATION — Be Soecific. (Note that a
contingency fee is prohibited pursuant to City Code Sec. 2-485.3):
$550 hr
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The tollowing six(8)questions MUST be answeletl:
1) Pursuant to Ciry Code SecEon 7-488, enfitled"Prohibded Campaign Conhibu6ons By Lobbyists On Procurement Issues`
_YesXNo: Are vou lobbvina on a oreaent or oentlina bitl for aootls. eauioment or sarvicas or on a oresent or
oentlina axard Tor aoods.eouioment or servlce4
2) Pursuant to Ciry Code Section 2490, enGtletl°Pmhibite0 Campaign Conbibutions By LobbyisGs On Real Estate Development
Issues"�: !
Yes/No: Are vou IobWina on a centlina aooliwtlon/or a Develooment Aareement with Me CIN or aoollutlon
fo�chanoe of zonina mao tlesianatfon or chanae to the Ciri's Future Lantl Use Mao7
3) Pursuanl to City Code Section 2-4ffi�h), any person (except ihose exempt from the tleFlnition of"IobbyisC as set forth in
Sec[ion 2-481)who only appears as a representative ot a nobforvprofit corporation or entity without spedal compensation or
reimbursemerri for ihe appearance,whether Oirecl or in0irecl to eapress support of or opposition to any item,shall registe�wRh
ine cit�y/Ge�rk as required by this section,but shall not be requiretl to pay any regisiretlon fees.
YeyWo: Are you reoreeeMina a no4/of-orofit corooatian or entlN wiMout sceclal comcenSeHon or
relmbunement7
4) Pursuant to City Code Section 2<81, the term "Iob�yisP' specifiwlly exGutles ihe following persons: Ezpert wi[nesses who
proviAe only scientifiq techniol or o�her spedalizea iniormalion or testimony in public meetings', any person who only appears
as a representa6ve of a neighborhootl associatlon withou[compensation or reimbursement for Me appearance,whet�er direct,
intlirect or contingent, to e�cpress suppotl of or opposition to arry Rem;and arry Derson who only appears as a representative of
no[-for-pmfit mmmuniy basetl organization for Ihe purpose of requesdng a grant without speaal compensation or
reimbursement/or�he appearance.
_Yes�Jo: Are vou orovidina onlv scientiflc. technical or oNer acecializetl in/ormatlon: aocearina as a
reoresentative oi a neiahborhootl aesaciation without soecial comcensatlon or relmbursement or
reoresentina a nof-for-oroftt basetl oraanizatlon for Me oumose of reouestino a orant vrithout
soeclal comoereatlon or reimbursament7
5) Pursuant to City Code Secfion 2d97�1), no cam0aign consultant shall lobby ihe Ciry Commission(or a penatl of 12 months
follovnng ihe sweanng in of any eleqed official(s)for whom the campaign consuflaM prwided campaign consulling services
within the past election cycle. See Section 2-091 for more inbrmaiion.
_Ves�lo: Have vou orovltleC camoalan consultlna servlces to an incum6ent mem6er of the CiN Commisaion
within the st el ion cle?If le se listthe incum0ent membe s of the CI Com lasion.
_Yes�No: It ves. ho It Ueen less ihan 12 moMhs eince the elecEetl o(ReiaNsl whom vou ororitletl umoalan
consultlna aervlces was swom in?
6) PursuaM lo City Cotle Section 2de2�aK4�a., a lobbyist who �as wHhin ihe past elecdon cyGe provided campaign consulting
services to an incumbent member of the City Commission(which lobbying activity is not otherv+ise prohibited Oy Cotle sec[ion
2�91) shall tlisclose such particular service on �is/her lobbyist regislration fortn and shall orallv Uiscbse such oartiwlar
s rvi re I in i ommission at a ublic meetin .
_Ves�lo: H v rovitled cam i n con ultin servi to an incumbent member o/ihe CI Commi ion
within the st eMction c cle9 M es kv li t ineum m m CI C mmlasion:
_Yes�o: If ves. were vou oromisetl or tlitl vou receWe economlc corrol0eratlon In eachanae tor umoslan
wmultlna sxHces?
y YL� TO BE COMPLETED BV CITV CLERK'S STAFF ONLV 2 ^�
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i:\CLER\SA���aFORMS\L09BYISTFORMS\Lo��yISIR�gISIrMiOnFOrm0.tri5¢Q 03-11-30REG.EM R!V{fld03/11/2�2�
Page 3 of 5
VI. SIGNATURES UNDER OATH:
ON FEBRUARY 28 OF EACH YEAR. EACH LOBeYIST SHALL SUBMIT TO THE OFFICE OF THE CI7V CLERK A
SIGNED STATEMENT UNDER OA7H LISTING LOBBYING EXPENDITURES AS WELL AS COMPENSATION
RECEIVED. FOR 7HE PRECEDING CALENDAR YEAR WITH REGARD TO THE SPECIFIC ISSUE ON WHICH THE
LOBBVIST HAS BEEN ENGAGEU 70 LOBBY. A S7A7EMENT SHALL BE FILED EVEN IF 7HERE HAS BEEN NO
E%PENDITURE OR COMPENSA710N DURING THE REPORTING PERIOD.'
Signature of Lobbyist Date
I do solemnly swear or affrm that all of the foregoing facts, statemenis, and discbsures in this form are true and correct,
and that I have read or am familiar with th rovisions contained in Chapter 2, Atl. VII, Division 3, entitletl "Lobbyists" of
the Miami Beach Ciry Code and all reportin equirements.
Signature of Lobbyist Oate /r- ryI�
Signature of Pnncipal: Date � 7 O� 1
VII. NOTARY SIGNATURE AND SEAL:
LOBBYIST: PRINCIP/iL
State o( State ot �� � �
County of: County of: �
Swom to(or affrmed)antl subscribed before me, Swom [o(or rmed)antl subscribed before me,
by means of O physical presence by means of physical resence
or O online notarization, or❑ nline notanz
this_day of . 20_, by [his�day of 20� by
Wesley Hevia Anthony Hsieh
NAME OF LOBBVIST NAME OF PRINCIPAL
ProducedlD ProducedlD
FORM OF IOENTIFICATION T ORM OF I�ENTIFlCATION
J
_Personalry Known _Per ly o
SignaNre of Notary Public Signature N ry blic
� � �e �
Name of No[ary, Typed, Printed or Stamped Name ot Notary, Typed, Printed or Stamped
(NOTARY SEAL) (NOT L�$�L)
,p^^�' LIIBEIHBUENO
� MYCOMYIS610NYHH77H2//
i�` .B� E%PIRES:DwenSx71.2020
'?.e:R�!'�'
' The term"lobbyist"specifcally exGudes Ihe following persons:
Expert witnesses who provide only scientifq technical or o[her specializad information or testimony in public meetings;any person who
only appeare as a represenWGve of a neighborhootl association without compensation or reimbursement(or ihe appearance,whether
direct, indirect or con[ingenl, to ezpress support of or opposition to any item; and any person who only appears as a representative of
not-for-proft communiN based organization for Ihe purpose af requesting a grent without special compensation ar reimbursement for
the appearence.
Page 4 of 5
VI. SIGNATURES UNDER OATH:
ON FEBRUARY 26 OF EACH YEAR. EACH LOBBYIST SHALL SUBMI7 TO THE OFFICE OF THE CITY CLERK A
SIGNED STATEMENT UNDER OATH LISTING LOBBYING EXPENDITURES AS WELL AS COMPENSATION
RECEIVED F R THE PRECEDING CALEN A � EAR WITH REGARD TO THE SP CIFIC ISSUE ON WHICH THE
LOBBYIST HAS BEEN ENGAGED TO . A STATEMENT SHALL BE FILED EVEN IF THERE NAS BEEN NO
EXPENDITURE OR COMPENSATIO ING THE REPORTING PERIOD.'
Signature of Lobbyist: Date ��_( � �LI
I do solemnly swear or affirm that all of the foregoing facts, statements, and disclosures in this form are irue and correct,
and that I have read or am Namiliar t e provisions contained in Chapter 2, Art. VII, Division 3, entitled "Lobbyists" of
the Miami Beach City Code and _ eporting requirements. �1 f/
Signature of Lobbyist: Date 7�� � 2 1
Signature of Principal: Date
VII. NOTARY SIGNATURE AND SEAL:
LOBBYIS�T: PRINCIPAL
State of__� State of
Counry of: County of:
S1vom to(or�ffirmed)and subscribed before me, Swom to(or affirmed) and subscribed before me,
by means of�physical pre nce by means of 0 physical presence
or❑ line notanzatio or O online notarization,
this�day of 20��Dy this_day o( 20_, by
Wesley Hevia Anthony Hsieh
NlVAE OP LOBBVIST NAME OP PRINCIPAL
1Protluce I _Produced ID
� ORM OF I�ENTIFICATION FORM OF IDENTIFICATION
V
_P Ily ���� _Personally Known
Slgnat f t� blic � SignaWre of Notary Public
r
Name of Nota Name o(Notary, Typed, Printed or Stamped
.•..•� IIIBEIHBUENO
(NOTARYSE , �,�u���x�3�N (NOTARVSEAL)
��:'� IXP4iES:UwMMr1;TOM
'The term"IobbyisP'specificalty ezcludes the following persons:
Expert wilnesses who provitle only srJeMific,technical or other specialized inkrmation or testimony in public meetings; any person wY�o
oMy appears as a representative of a rieighborMotl association without compensation or reimbursement for the aDDearence,whether
direct, indirect or contingen( to express suppoR of or opposition to any item; antl any person who only appears as a representative of
not-for-pmfit wmmunity basetl organization for the purpose of requesdng a grant withouf special compensation or reimbursemen� for
the appearence.
Page 4 of 5
City d Miami Beaih, 1700 Convenfion Cenler Driva,Atiami Beo<h,fbrida 33139,ww�w.miamibeochA.gov
OHice of ihe Ciry Clerk
Rafael E.Gwnado, Ciy Clerk CiyClerk�miomibeochH.gov
Tel: 305.673.7411, Fax: 305.673.7254
NAME OF LOBBYIST: Wesley Hevia
1) LOBBYIST FEE EXPENDITURE AND COMPENSATION STATEMENT
Pursuant to City Code Section 21185(d), the City Clerk shall notiry any lobbyist (or
principal)who fails to file timely a Lobbyist Fee Expenditure and Compensation Statement
(Statement). In addition to any other penalties that may be imposed as provided in
Seciion 2�85.1, a fine of $50.00 a day shall be assessed for Statements filed aRer the .
due date. The City Clerk shall notify the Miami-Dade County Commission on Ethics and
Public Trust of the failure of a lobbyist (or principal) to file the Statement or pay the
assessed fines aker notification.
Any lobbyist, who fails to file the required Statement by April 30'" of each year, shall be
automaticaily suspended from lobbying until all fines are paid, unless the fine has been
appealed to the Miami-Dade County Commission on Ethics and Public Trust.
I hereby acknowledge that on February 28 of each year, I shall submit to the City Clerk a
signed Statement under oath listing all lobbyist expenditures, as well as compensation
received, for the preceding ralendar year with regard to the specific issue on which I have
been engaged to lobby.
2) LOBBYIST WITHDRAWAL
Once an issue I have registered to lobby has concluded or I am no longer lobbying on
that issue, I shall immediately file a Notice of Withdrawal with the Office of the City Clerk.
3) ANNUAL LOBBYIST REGISTRATION FEE
I understand annual registration of all lobbyists shall be required for each 12-month period
commencing October 1 of each year, and the fee for such annual registration shall be
$500.00 pursu o Section 2-482 of the Miami Beach City Code.
3 -y- z�
Signature of Lobbyist Date
F\CLEPRALL�aFOPMSLL06BVI5T PoRMSLLoCOyltl Reglsl2lun Porm RePee�03-11]0 REG hu'
Page 5 0(5
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(THIS INFORMATION MUST BE COMPLETED) By
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