FY 2024/2025 Annual Lobbyist Registration Form n�n', I %�.^✓nI �3EA��'' RECENED
City of Miami eeach SEP 27 2024
1700 Convention Center Drive
Miami Beach, Florida 33139 CITY OF MIAMI BEACH
www.miamibeachfl.gov OPFICE oP THE Clry CLERP
City Clerk's Office
Tel: 305-673-7411
Fax: 305-673-7254 oer�e usa oniy
ANNUAL IOBBYIST REGISTRATION FORM
Name:�111V� '/� 1/ la �
Business Name: r( q U 2 I f �� F �O��r�9
Address: Q�� � V� 13184 �S-F p��c'�SI9J °L9 F(- 33�"33
OfficeTelephoneNumber: ��3 � 8�"'� - �J� 3s
Cellular Telephone Number: 2 � S " 2�'2 - 8 3 'S 3
EmailAddress: q V��"1, f��2 � ` CqJ9 � �'�y ��ol�ida . o� q
I/more fhan one lo6byist,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.
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