2024 Lobbyist Registration Form - 34 Star Island DR (Anthony Hsieh) 3y 5l�.��s)o.,�,�
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MIAMIBEACH Ot�ceoftheciryC�erk �' 1 �" �024
1700 Convention Center Drive
Miami Beach, FL 33139 , �"1'FMI B:AC.�i
305.673.7411 - � . . . . .-'":
LOBBYIST RE613TRATION FORM
Lob6yist means all persons employed or refeinetl, whether paid w not, by a principal who saeks to encourage the passage, defeat or
motl�cation of any ordinance, resalution, action or deasian of any commissioner, any atlion, decision, recommentlation ot the City
Manager or any City boerd or commidee;or any action,dedsion or recommenda6on oF any Ciry personnel during the time period of the
antire tlecision-making process on swh action, tledsion or recommendation thal toreseeably will be heaM or reviawed by ihe CiFj
Commission, or a Cily boarG or cwnmitlee. The Mim specifically i�utles the principal as well as any employee engaged in lobbying
aclivities. Tha tertn"LODhyisP has spepfic exdusians. Please refer to City COEe CMpler 2,ANcle VII, Divisian 3, enMled "Lobbyists,"
/or additional information.
Inatruntlonc: Please wmplete all setlions of Mis fortn aM submit Me completed foim,wM ihe applica6le fee,to the Office of ihe Ciry
Cletic. If you rreed more space to complete an enswer, use a seperefe sheet(s) of paper. If you have rrot�ing lo report in a particular
section, you must write 'none or 'n/a° in that section. Any change to arry intormation originally filed, or any addNonal City
Commissioner ar personnel who are elw wu9ht lo be lobbied shall require ihat Ma lobbyist file en amendment to ihe regisUetion form.
The lobbyist has a contlnuing duly to supply information antl ameM the fortns (led throughout the penod that the bbbyi� occurs.
Seperate regisiretion torms shall be required(or eac�pnndpal representetl on each spedfic issue.
I. IOBBYIST INPORMATION:
Fischman Paul
NAMEOFLOBBVIST (last) (Fint) (MiEdleName)
CLF Architects 8425 Biscayne Blvd Sude 201 Miami FL 33138
IOBBVISTBUSINESSNAMEANDADDRESS (NumberandSereeq (City) (State) (ZipCOEe)
305-434-8338 pfischman@c�farchitects.com
LOBBYISTBUSINESSTELEPHONENUMBER CELLULARTELEPHONENUMBER EMAILAWRE55
II. PRINCIPAL INFORMATION:
Hsieh Anthony
NAME OF PRINCIPAL (lesp (Firmp (Mitltlle Name)
JLSA Star LLC 34 Star Island Drive Miami Beach FL 33139
PRINCIPALBUSINESSNAMEANDADDRESS (NumberandStreep (Cdy) (Sfete) (ZipCode)
617-710-7023 mauricegriotllc@gmail.com
PRINCIPALBUSMESSTELEPNONENUMBER CELWLARTELEPHONENIIMBER EMAILADDRESS
Purouant W Ctty Code Sadion 2-0ffi(hH�)(e): A prirwipal of eny corporetion, partnership, or oMer eritRy who appean ef a bbGyot an beheH M lhet
eMGy,wilhout�peciel oompeneation or reimbunemeM(or ihe appearence,wheUtt tlireµ iMirect,or continpen4 to ezpreea aupport M or oppoartbn m
an item chall repieler wM Me Ck�k ea requireE by this subsection Cut ahall not be raquired to pey eny registration feas.
Ii fhe principal is a Corporation, Partnership or Trust, the following intormation MUST be provitletl
pursuan!to City Cods Seclion 2-482�c):
• NAME OF CHIEF OFFICER,PARTNER,OR BENEFICIARY(if nons,wrlte NIA): '�ShOfly HSI@h (SOI@ MBrtIbBfJ
• NAME OF All.PERSONS HOLDIN6,DIRECTLY OR INDIRECTLY,A 6%OR MORE OWNERSHIP IN7EREST IN SUCH
CORPORATION,PARTNER9HIP OR TRU9T(H nons,vMts N/A): AMh011y HS10h (S018 MBfflbEf)
Pape 7 of 6 �� x ,
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111. ISSUE TO BE LOBBIED:
Describe with as much detail as is praelical, ineluding but not Iimited to a specific deseription where
appfloable of a pendinp request for proposal, InviWtion to bid, or public hearing number.
Development approvals&permitting issues, inc�uding, but not limited to Members of the Ciry Administretion,
Members of City Staff and Members of HPB, PB, DRB, and BOA, City Commission and Mayor, relating to
The property located at 34 Star Island Drive, file number OR623-0963.
IV. CITY AGENCIEB/INDIVIDUALS TO BE LOBBIED:
PursuaM to CiSy Code Section 2-482�a)�4�, Ilst !he City Commissioner or City psrsonnel sought to be
lobbied, and whether the lobbyis! has entered into any contnetual rolationship (paid or unpafd� with
sald City Commissioner or City personnel from 72 months preeeding such commencement oT service
with the Cily to tha present date,stating fhe general naluro of the subject controctual relationship.
Full Nams of Individual and CoMnetual Relationshlp(M yas, explaln) vE5 No
Tida M Parson W bs Lobbietl
Members of City 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), C Commission and a or X
PurswM to CIly Coda Section 2�482(p�, every reglstranS ahall be required to sUte !M axtent oi any
6usiness, flnanclal, Tamilial or p�ofesslonal rolationship, or other relaUonship giving rise to an
appearonce of an impropriety, wtth any eurront City Commissioner or Cfiy personnsl who Is sought to
be lobbled as identifled on She iobbylst repistratlon fortn filmd.
List any Business, Financial, Familial o� Professional Rslatbnship, or ofhsr nlatlonship givinp Mse to an
a arancs of im ra rle H none write IJIA :
N/A
V. DISCLOSE RATE AND AMOUNT OF LOBBYIST COMPENSATION — Be Saseific. (Note !ha!a
contingeney fee is prohibited purauant to City Code Sac. 2-486.3):
�� ����(1fk� [�1{�(L�Ci�o(1
Paga 2 of 6
7he}o1lowln0 six(8)questlons MUST be arovwred:
1) Pursuant ta Ciry Cotle Section 2dB8,antNetl"Pmhi6detl Campaign ContriCutions By LobGyists On Procurement Issues":
_yasxNo: � n wsa�M or o Jidlna Wtl for noo0e ea loment or sa i or on a ras nt or
otndMaawardforaoods aaulomeMoreervle T
2) Pursuent to City Code Seclion 2190, en4Getl"Prohibitetl Campagn GontriOubons By Lobbyists On Real Esta[e Development
Issues"�. /
Yas/No: Are vou lobbvina on a wndina aoolloatl n(or a DeveloomaM A reama t wNh the Cin or aoolbada�
nae of z Mna mao denl notlon m h^ e t�pro GMv's Fu* n L d Uu Maot
3) Pursuant to Cily Coda Section 2.18Y�h�, any person (ezcept those ezempt 1rom the definition of"IobbyisC es set farth in
Sectlon 2-087)who only appears es a representetive of a not-�w-profil coiparation or enGty wilhou[special wmpensa4on or
reimbunement for the appearance,whether direct or indirecl to express support of a opposition ta any item,shell register wilh
lhe city clerk as required by this sectioq Dut shall not be requiretl to Day any registra6on fees.
_Yeg�lo: a �o� na�es ntlna a not-lonoroflt o roorotlen or eMitv wiNout soselal comumsatlon or
rsim6uroament?
4) Pursuant to Ciry Cotle Seclion 2J87, t�e le�m "bbbyisP specificalty ezdudes lhe follovring persons: E:pert witnesses who
provide onty sctientific,technical or other spacialized infortnation or testimony in puWic mcelings; eny parson who only appears
as a representative of e neighborhootl association vnthout compensation or raimbursement fw Me appearar�ce,whether tlired,
indirect or contlrgent,ro express suppoA of w opposflion to any item;end any person who onry appears as a represaMative of
nobforvprafit communiry 6ased organ¢alion for t�e puryose oi requesting a grant withoul special compensation a
reimbursemen[for ihe appearance.
_Yn�lo: e orovltllna 1 xlentlflc le hnieal or oMsr soselalWd i hrmatlon� a w rin as a
reereeanfntive of a rwlahborhood oasoalal�n wHlwut soselal comoensatlon or rolmbunamant or
roorsce� ot-Mr-orofk basad oraanLtlon tar fhe rooss M m tlna a annt without
soselal aomoensatlon or nim6ursemeM?
5) Pursuant to Ciry Code Section 2d91�1), no campayn consuttaM shall lobby ihe City Commission for a period of 12 monihs
tollowing the swearirg in of any eladed otficial(s)for whom the campaign consultant provitled campaign consultlng sarvices
within the past election cycle. See Seciion 2�191 for more in/ormetion.
_Ves�lo: H v vou orovided moalan arn Itlna sarvlw to an Incumhan!memMr of th CIN Commlasion
+'H oast alw" evels9lf v le sa Ilst the Ine��beM mamherlsl oHM CHv Commission:
�ye3�1o: •,•-- �� IL bsan less 12 moMh I u th� eleand aRleiallal wham vou oroviEed mmmlan
eonsulUna urviws was cwom In?
B) PursuaM to Ciry Code Section 2deY�a��4�a., a bbbyist who has within the past election cyde provided campaign conwlting
services to an incumbent member of tha Cily Commission(which lobbyirg acdv'ity is not othenvise prohibited by Code section
2-491) shall disGose such perticular service on his/her bbbyist registra4on form d �rt_II wellv tli �o� � h oart'alar
ce before bGb ' Ihe C1N C et e bl' eeli
_Yea�lo: H' _ ' ' ___'' _' _""_' _"' W__"'.�_.�_.. .... ....w.......i....a x..r w r.,....nt.:�.,�
... in fhe aast flxtlan ovcle7 M 96 OIG9N II'[LA I � ben[ am6sN 1 of tM dN Commisslon�
�Yl5�0: If "� MH OL Ofd111Yld dld VO4' RCO� lEG110111�0 COIIt1Elfi1�0l1 III �YCh01q� fOf W111D01011
COIIBYI�IIIO 6lN16M9
V�o�fS� a.:y TO BE COMPLEfED BV CITY CLERK'8 BTAFF ONIV
nnvd e. � OSO,��AICRI 33�5 OmPaitl� ���y
Annu�l Rpisb�tlan M: ( ]Y�a ]No Amount P Cid�
Lobb1'icl RN�ctnlia,Pom,,.e«r.d.�d,,.,iR�d M:J1M
F:\CLER\{ALL\aFO0.M5\LOBBYISTFORMS\lobbyistReqirtrationPormRevlud W-S140REG.doc RlV�!lCO3/11/7010
Page 3 of 6
VI. SIGNATURES UNDER OATH:
ON FEBRUARY 28 OF EACH YEAR EACH LOBBYIST SHALL SUBMIT TO THE OFFICE OF THE CITY CLERK A
7 STATEMENT UNDER OATH LISTING LOBBYING EXPENDITURE3 A9 WELL AS COMPENSOTION
owcrcDlNG CALENOAR YEoR WITH REGARD TO THE SPECIFIC ISSUE ON WHICH THE
LOBBYI3T NAS BEEN EN6AOED TO LOBBY A STATEMENT SHAIL BE FILED EVEN IF THERE HAS BEEN NO
c oc n�ruwe n r ennu ni TF{E REPORTING PERIOD�
Signature of Lobbyist Date
1 tlo solemnly swear or�rm Mat all of the Porepoing facts, statements, antl tlisclosures in this krm are true and wrrect,
antl that I have reatl or am familiar with the provisions containetl in Chapter 2, Art. VII, Division 3, entitled "Lobbyists° of
the Miamf Beach City Cotle and all reporting requirements.
Signature of Lobbyist: Date
Signature of PrincipaC 1 a�--�� Date 2 �s� Z y
—� V
VII. NOTARY SIGNATURE AND SEAL:
LOBBYIST: PRINCIPA
State of State of � U �V{ � p
Counry of: Counry of. � Ul
Svorn W(or affirmetl)and suDscribed before me, Swom to (or affirmetl)and subscnbeC before me,
by means of O physical presence by means of�p1 physical presence
or O online notanzation, or O orline notanz ti i n'1
this�tlay of . 20_, by this 5 day of� � 26��`t, by
Pau� Fischman Anthony Hsieh
NAME OF 1O88YIST NAME OF PRINCIPAL
Protlucetl ID _PrOtlucetl ID
FORM OF IDENTIFICATION � F/�� M OF IDENTIFICATION
_Personally Known _Pers na'll ,1O n
I
Signature of Notary Public Signat re of otary Pub
�� �
Name of Notary,Typetl, Printed or Stamped Name of Notary, Typed, Printetl or Stampetl
(NOTARY SEAL) (NOTARY SEAL)
ii� ..,,
�`� ��.: LIieE7HBUENO
?4' A`c
MY COMM44SION f'�HH J7dP14
' The lerm"IobbyisC'specfiwlly exGudes Ihe following persons�. ''�°%"°'' �S'D�a�Mw�Z,2�!
ExpeA witnesses wha pmride only scientiGc,techoical or other speciel¢ed iniormalion or testimony in public meetings;any person who
only appears as a repressntativa of a naighborhood association without compensation or reimburument for the appearance, w�eUer
direcl, intlired or wntlngent,W ezpress support of or opposiNon to any item; and any person who only appears as a representaEve of
no4tor-profit communiry based organizalion kr the purpose of requestirg a grent wdhout special compensa0on or reimbursement for
tha appeafance.
Page 4 of 6
VI. SIGNATURES UNDER OATH:
ON FEBRUARV 28 OF EACH YEAR EACH LOBBVIST SHALL SUBMIT TO THE OFFICE OF THE CIiV CLERK A
SIGNED STATEMENT UNOER OATH LISTING LOBBYING EXPENDITURES AS WELL AS COMPENSATION
RECEIVED FOR THE PRECEDING CALENOAR YEAR WITH REGAR� TO THE SPEGIPIC ISSUE ON WHILH THE
IOBBYIST HAS BEEN ENGAGED TO LOBBV. A STATEMENT SHALL BE FILED EVEN IF THERE MAS BEEN NO
EXPENDITURE OR COMPE 0 URING THE REPORTING PERIOD.'
Slgnature of Lobbylst ' Date����`i
'
I tlo solemny swear or affirtn t�at all o(the foregoing facts, statemenis, and disclosures in lhis fortn are Irue and correct.
and thal I have read or am�a�h t{k pmvisions contained in Chapter 2, AR. VII, Division 3, entdled"Lobbyisls' of
the Miami Beach C�.Gatle nd alLrSnoMng requirements.
���
SignaNre of Lobbyist: � Date Z� I + 7<1
Signature M PrinciDaC � � Date
VII. NOTARY SIGNATURE AND SEAL:
IOBBYI$T: \ PRINCIPAL
Stateof ����� L"U Stateof_
County of: N ��U11'1 - �fW County of:_ _ _
Swom lo(or aN�med)and subscribed before me, Swom to(or a�rmad)and subscribed before me,
by means of�physicai presence by means of�;physical presence
or 0 onli�a notarization, or O online notanzation,
this 1 ' tlay of '�'e�a�vi�_202�!by this_ tlay of .20 hy
Paul Fischman Anthony Hsieh
NAME OF LOBBYIST NAME OF PRINCIPAL
Produced ID Produced I�
FORM OF IDENTIFICATION FORM OF IpENTIFICATION
�Personally Known .'errconally I�[w+yn
�—P� �,�_
�� �� "1i
Sgnalure W Notary Public Signature M rvolary Public
�Wl^L1 �P 1Zfl�1 .>
Name of Notary,Ty�. ,;�nCIM�p Name of Notary,Typetl, Printed or Stamped
ly�� NATASMApF0.EN21$
(NOTARVSEAL) NotaryPublic S[a[eoiilonea (NOTARVSEAL) P NATASHaOEREN2IS
'�"�a�j Cammisslon k HN H6456 F �`-. Natary Publ c State of FloriEa
My Cdnm Exp res Jun E9,IDt] � �`� Commrsvan p NN 91615fi
'��6onEeEtMwqhNa�ianalNMaryAssn. �,mh°..��'� MyCwnm.EspireeJunt9,30t]
'The tertn"IobbyisY'speafl I y ex u e h o owin s. ���BonEed t�mugh Natimal Notary Assn.
Eapert witnesses who provitle only suentific,techniwl or other special¢etl information or testimony in pu�lic meetings�,any person who
anty appeers as a representative of a rreig�boihootl assouaGon wilhout campensa�ion or raimbursemenl fir the appearan�,whether
Girep, intliiect or wMiigen4 ro expmss support o(o�opposilion�o any item',antl any person who only appears as a representaGve of
� no4hr-proffi communiry base0 organiietlon k��he purpose of repuesting a grant witM1out special wmpensaUon or reimbureement for
th¢appearance.
i Page 4 of 5
. . . r, — �. — ._.
C(y o/Miemilesh,1700 Gomenfion Cenbr Drhe,Mtoml Beach,Flarida 33139,www.miamibeachA.ge.
Oflice d ihe Cily Clerk
Rakd E.Gmiwdo,CiyClerk CiryLlarkBmiamibeachB.gm
Tel:305.673.7411,Faa:305.673 7754
NAME OF LOBBYIST: Paul Fischman
� 1) LOBBYIST FEE EXPENDITURE AND COMPENSATION STATEMENT
� Pursuant to City Code Section 2-085(d), the City Clerk shall notiTy any lobbyist (or
�, principaq who tails to file timely a Lobbyist Fee Expenditure and Compensation Statement
(Statement). In addition to any other penalties ihat may be imposed as provided in
Section 2-085.1, a fine of $50.00 a day shall be assessed for Sfatements filed after ihe
� due date. The City Clerk shall notify ihe Miami-Dade County Commission on Ethics and
I Public Tmst ot the failure of a lobbyist (or principap to file the Statement or pay the
� assessed Flnes afler notification.
i Any lo6byist, who fails to file the required Statement by April 30'^ of each year, shall be
aulomatically suspended from lobbying until all fines are paid, unless the fine has been
� appealed to the Miami-Dade County Commission on Ethics and Public Tmst.
II 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 lhe preceding calendar year with regard to the specific issue on which I have
I been engaged to lobby.
• 2) LOBBYIST WITHDRAWAL
IOnce 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 ursuant to Section 2-082 of the Miami Beach City Code.
` ___- 2 � I � '`�
Signature of Lobbyist � Date -T �
F`LLEP1tALLbFOfiNSLLOBBYiSiFOFMSYNb�+s�RpbtivYmFwmReNeW�311�30REGOz
Page 5 W 5
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Received of
Address
For
MBF
Miscellaneous- MCR-202d
006740-0001 Adrian V_. OP113/2024 04'47AM
MCR OPEN(MCR) Offlt2 Of F10811[2 DIfBCYOf
Paymen[AmourR: 7,OSD.OD
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