2024 Lobbyist Registration Form - 34 Star Island DR (Anthony Hsieh) _ 3L/ S�-��J�
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MIAMIBEACH OfficeottheCiryCleB ��� � � `024
1700 Convention Canter Drive '��JiTY OF MIAMI 6cACH
Miami Beach, FL 33138 �t � - � `� '�°'�Rk
305.873.7417
LOBBVIST RE616TRATION FORM
Lobbyist meana all persons employed w re�ained, whether paid or not, by a principal who seeks to encourege the passage, tlefeat or
modification of eny ortlinance, resolWon, ac6on or tlecision of arry commissioner; any ection, tlecision, recommendation of ihe City
Manager or any Ciry board or comminee;or any action,dedsion or recommentlation of any City personnel during the tlme period oHhe
enGre decision-meking p�ocess on suc0 action, decision or recommarMation thet foreseeably will be heaN or reviewed by Ma City
Cammission, or a City boartl or commdtee. T�e tertn specifically inclutles the pnndpal as well as any employee engagetl in lobbying
activi0es. The tertn "LobbyisP hes spedfic exclusions. Please refer to City Cotle Chapter 2, ArtiGe VII, Division 3, entltled"Lobbyists,"
foredtlitionalinfortnation.
IneWetlo�: Please complete all sections ot t�is foim and submil the completed fortn,with tha applicable fee,to ihe Office of Ihe City
Clerk. If you need more space�o complete an answer, use a sepa�ste sheet(s) of papar. If you have rrothing to report in a partculer
seclion, you musl wdte "none" or "Na° in that sactioa Any rhange to any intormation onginally fileA, or any additional Ciry
Commissioner a personnel who are elso sought to be lobbied shall require that Me lobbyisl file an amentlmerrt to the regislration tortn.
The lobbyist hes a continuing duty lo suppty informafion ana amend ihe forms filed throughout Me penod ihat lhe bbbying accurs.
Separale regfstration fortns shall be requiretl for each prindpal reprasented on eech speci(c issue.
I. LOBBYIST INFORMATION:
Choeff Ralph
WIMEOFLOBBYIST (Lesq (First) (MitldleName)
CLF Architects 8425 Biscayne Blvd Suite 2D1 Miami FL 33139
LOBBYISLBUSINESSNAMEANDADDRESS (NumberandStreeq (Ciry) (Stete) (ZipCode)
305-434-8338 rchoeff�Qclfarchitects.com
LOBBYISTBUSINESSTELEPMONENUMBER CELLULARTEIEPMONENUMOER EMAILADDRESS
II. PRINCIPAL INFORMATION:
Hsieh Anthony
NAM1E OP PRINCIPAL (Lasq (Firsq (Mktlk Neme)
JLSA Star LLC 34 Star Island Drive Miami Beach FL 33139
PRINCIPAI USINESS NAME hND ADDRESS (Number and Streep (CMy) (State) (Zip CaAe)
617-710-7023 mauricegrlotllc�gmail.com
PRINCIPAL BUSINESS lELEPHONE NUMBEft CELLUTAR TELEPHONE NUMBER EMAILAOORESS
Purouanl W CHy Cotle Sedion 4482(h)(1)�e): A pnncpel of a�ry corpore[io^. paManhip, or dher entiry w�o appeerm as a lobbyiat on bahaH of Met
enlity,without apecial wmpenulion or reimburasmaM br the eppeera�e,whether dired,iMimcl,ar condrpent,ro axpreu suppoM1 of w oppoai[bn to
an ttem ahell regiater with the Clerk aa raquirad by thu subaeclion Wl ahall rro[Ee required W pay eny repictralion feas.
Ii the principal is a Corporation, PaRnership or Trust, the tollowfng intortnation M T be providW
pursuant to City Code Section 2�482�c):
• NAME Of CHIEF OFfICER,PARTNER,OR BENEFICIARY(I}non�,wrib NIA�: AflfhOfly HSI@h (5018 MBfllb2f)
• NAME Of ALL PERSONS XOLDINO,DIRECTLY OR INDIRECTLY,A 6X OR MORE OWNERSXIP INTERE9T IN SUCH
CORPORATION,PARTNERSHIP OR TRUST(If norro,wrlb N/A): Anthony H51@h (5018 MembBf)
Page 1 of 6 }�
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II�. ISSUE TO BE LOBBIED:
Describe with as much detail as is prectical, including but not limited to a speciflc descriptfon where
applicable oi a pending request tor proposal, invitation to bitl, or public hearfng number.
Development approvals&permitting issues, including, but not limited to Members of the City Administration,
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 DR623-0983.
IV. CITY AGENCIES/INDIVIDUALS TO BE LOBBIED:
Pursuant to Ciiy Code Section 2-482�a�(4�, list the City Commissioner or CiSy personnel sought to be
lobbted, and whethar the lobbyls! has entered into any eontractual relaSionship (paid or unpaid) wilh
saltl City Commissioner or City parsonnel from 12 months procedinp such eommencemen! of service
with the Cily to the present date, stating the peneral nature oi the subject contractual �elationship.
Full Nams of InAlvidual anC Controclual Retationship(N yes, explain) vEs No
TRIa W PeBon to bs lobbiW
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), Ciry Commission and ayor X
Pu�suaM to City Coda Seetion 2-482(g), every registrent shall be required W stale the extent o} any
business, tinancial, famllial or professional relallonship, or other relatfonship giving rise !o an
appearance of an impropriety, with any current City Commissloner or City personnel who is sought to
be lobbietl as idenliffatl on She lobbyis! registrelion form flled.
Lis! any Business, Finaneial, Familfal or Professional Ralatlonship, or other reletfonshfp pivinp rlsa to an
a aronw ot im ro ris H none wAa PllA :
N/A
V. DISCLOSE RATE AND AMOUNT OF LOBBYIST COMPENSATION — Be Soeci£c. (Note that a
contlngency fes is prohibited pursuant to City Code Sec. 2-486.3):
���1���� �\ P�M,,��nC�1�Q
Page 2 of 6
The lollowing sl:(8)questlons MUST be answeratl:
1) Pursuan�[o Ciry Cotle Section 2J88,entitled"Prohibhed Campaign Coninbutions By Lob6yis(s On Procurement Issues":
_Y�No: A voG lobb•ina on - rasent r ndlna bid f r aoods aul nt or servleas. or on a wesent or
osntllna awartl for 000ds.aaulomant w sarvice?
2) Pursuant to Ciry Code Seclion 2-480, enti0etl"Prohibitetl Campaign Contributlons By Lobbyists On Real Estate Development
Issues"�: [
Yas/No: I bbvin a oerWl o oollwtl n for a Da looment n �en! Ith the CIN r aoollcaG
Tor¢h n e ot zo I m o tl I on h rwe Lo tli Cilv's Futu Land U M o9
3) Pursuant to Cdy Cotle Section 2Jffi�h�, any person (excep[ tYwse exempt from the definttion of "IobbyisC as set foM in
SecGon 2-081) who only appears as a representative of a no4Por-profit coryorefion or entiry wilhout special compensation or
reimEursement for the appearance,whether direct or intlirect to express support of or opposilion[o any item,shall register with
the ciry clerk as required by this section,but shall nm be requlred to pay any regislra6on fees.
_VeS�No: A vou r res�Mina �wt for-o fit com tl n or e !IN wltli ! soecfal eomoenwtlon or
rolmbursement4
4) Pursuant lo Ciry Cotle Section 2d87, the tertn "IobbyisP' spec�calty ezGudes the following persons: Expert witnesses who
provbe onry scientifiq technical or other spadal¢ed intortnation or tesfimony in pudic meetings;any person who only appears
as a representative of a neighborhood association without compensation or reimbursement for t�e appearence,whether dired,
intliract or contingenf,to express support of or opposition to any item;and any person who onty appears as a repreuntalive of
no4for-profil community Oased organizatlon for the purpose of requesting a grant withoul speciel compensation or
reim6ursement fM the appearance.
_Yes�lo: A vo� o Itlina o I• s IeMlflc b hnlcal other s iallzetl I fortnatlon� atlno aa a
ood x1aG witlwut I I eomoe mtlon o I burs�m t o
enLna ot-!or orofit b.setl ra3nizstlon t the ou a of roa tln a a t wlMout
s ial oomoe atlon or rei 6uroemeM9
5) Pursuant to City Coae Section 2�97�7�, no campaign consultant shall labby the City Cammisslon tor a penotl of 12 monihs
following the sweanng in M any elected official(s)for whom ihe campaign consultant provitled campaign consu�ing services
within the past election cyGe.See Sedion 2-091 for more informa6on.
_Yes�lo: Have vou orovitletl c moalan corroulGna a fu to an I m0ent amber o}th CIN Co la lon
wrthi fhe w t Iwtl n le7 IT ve laaee IISS[he Incumhs t membeAcl of Me CNv Comml I rc
_Yed�No: s It b:a lass tha 12 Mh i ee tlu �aeted offl I Ilsl whom vou orovlAed eamoalan
eonsuldna sarvfees wae awom In?
fi) PursuaM to City Code Section 2-0BY�a��b)a., a lo6byist who has within Ihe past eleclion cycle provitletl campaign consul�ing
services to en incumbeM member of lhe City Commission(which lobbying acfiviry is not otherwise prohibited by Code sectbn
2<91) shall disclwe such particular service on his/her lobbyist regislration form ' d shall II Oi�^ ^ = ch oartic I
I I�M1 ' tM C N C [ bl m¢2l
_Yes�lo: y�+gv orovidad mm0.lan ns�ltlna urvicea t a 'ncumbe t mem0e f tlie CIN C misslon
�n eVt1871f Vaa Ww IlSttliB in benl memheN91 i tlro CHv C i lon'
_Yes�lo: vou oromleed w did u rooei wno i onsltleratlon In exah noe for w wian
consultlna servloasT
�(G�ioVS) �e:d TOBECOMPLETEDBVCITVCLERK'S8TRFFONLY
qnual k� / /�� o0
AnnudRpislntioaM: I 1Veslr]No AmounlP�aldS►//�O, MCRR �30� D�tePai ��� ��
LODbyfst Rpistntion Form nwivM md v�riR�d by'/ J-/
F:\CLER\SA��1aFORMS\LOBBYISTFORMS\�oCbyistReg�stnHonPormReviutl U333-20REG.tl« RlYISCd03/Il/111I0
Page 7 of 6
VI. SIGNATURES UNDER OATH:
ON FEBRUARV 48 OF EACH VEAR EACH L088VI5T SNALL SUBMIT TO THE OFFICE OF THE CITY CLERK A
SIGNED STATEMENT UNDER OATH LISTING LOBBVING EXPENDITURES AS WELL AS COMPENSATION
RECEIVED FOR THE PRECEDING CALENDAR YEAR WITH REGARD TO THE SPECIFIC ISSUE ON WHICH THE
LOBBYIST HAS BEEN ENG 0 TO LOBBY. A STATEMENT SHALL BE FILED EVEN IF THERE HAS BEEN NO
EXPENDITURE OR COMP TION D RING THE REPORTING PERIOD.'
SignatureofLobbyisf�. Date �� 1 IZ�I
I do solemnly swear or atfrm ihat all of ihe foregoing fac[s, s�atemenls, antl Cisclosures in this fortn are tme antl coRect,
and lhat I have read or am (amiliar with ihe provisions contained in Chapter 2, AN. VII, Division 3, entdled"Lobbyisls' of
[he Miami Beach City Code all reporting requirements.
Sgnature W Labbyist Dete �� I 2L�
Signature of Principal'. ___ _ Date
VII. NOTARY SIGNATURE AND SEAL:
LOBBYIST: PRINCIPAL
s�a�a or h 1 u v�clrn s��a oe
Counry of i`�1' Uw'� - ��u��4 County ot_
Swom to(or affrmetl)antl subscribed before me, Swom to(or affirmed)and subscribed before me,
by means of�Fphysical presence by means of�p ysical presence
or�online notarizatioq or O onlina notam=°n-
this V 1 f day of C r bV�202�bY this 3y of. � _�2C �Y
Ralph ChoeN Anihony Hsieh
NAME OF�OBBYIST NAME OF PRINQPAL
_Protluce0lD _Produced ID
FORM OF IOENTIFICATION FORM OP IDENTIFlGNTION
�' Pereonally own _ ersonalN K�m���
��-
SignaWre M Notary Public Signature of Nolary Public
NG�FU11,u �l� �n2n �
Name of Nolary,Ty ame or rvotary.Typed, Printetl or Spmped
NATASHA OE RENZIS
(NOTARYSEAL) f� �'':. No�nryPublic Staieo�fionea NOTARVSEAy �, eaTtSHaDERENZiS
'���'� MYCammSEypiesluvE951031 `'����'�� NoCmmublionktXH4)645fi1Ea
BmdeEthrouqANationalNotarylssn. \�ypd,�` MyComm.ExD��esJun29,3011
'The tertn"IobbyisC apecifi ����Bonded MrougA NaHmal Nohry Atm.
I ExpertwiViesses who prmide onty scierrtific,technicel or o�her specializetl Infortnatlon ortestimony In public meetings;any person wha
only appears as a repreaentetive of a neighborhooC assacietion wiMoul compensetlon or reimbursement fur Me appeardn�,w�ether
Cirect, irbirect or continBent,ro aspress support ot or opposition ta any item; aM any person who only appears as a represantative of
I no4�m�mfit cammumN basetl o�ganization hr the purpose of requesting a grant wtt�out special compensation or reimbursement kr
ihe appeerence.
Page 9 of 5
VI. SIGNATURES UNDER OATH:
ON FEBRUARY 28 OF EACH YEAR EACH LOBBYIST SHALL SUBMIT TO THE OPFICE OF THE CITY CLERK A
810NED STAT 117ENT UNDER OATH LISTING LOBBYING EXPENDITURES AS WELL AS COMPENSATION
IVED FOR THE PRECEDING CALENDAR YEAR WITH REGARD TO THE SPECIFIC ISSUE ON WHICH THE
� OBBYIBT HAS BEEN EN6AGED TO LOBBY A STATEMENT SFioLL BE FILED EVEN IF THERE HAS BEEN NO
�XoFNDITURE OR COMPENSATION DURINC TNE REPORTIN6 PERIOD�
Signature of Lobbyist Date
I do solemNy swear or affirm that all of the foregoing facts, sfatements, and discbsures in Mis form are true antl correct,
antl that I have read or am Yamiliar with the provisions contained in Chapter 2, Art. VII, Division 3, entitletl "Lobbyists' of
the Miami Beach City Code and all reporting requirements.
Signature ot lobbyist Date
Signature of Principal: JL_� Date��
VII. NOTARY SIGNATURE AND SEAL:
LOBBYIST: PRINCIPAL (�
State of State of �!`1��t-��J\�1 \
County of: County of: 11\��11\� 11YlU�
Swom to(or affirmed)antl subscribed before me, Swwn M(or a�irmed)antl subscribed before me,
Dy means of� physical presence by means of d physical presence
or O online notarization, or�online notariz io ntI
this_tlay of . ZO_, by Mis�day of ' � 20"[y by
Ralph Chceff Anthony Hsieh
NAME OF L08BYIST NAME OF PRINCIPAI
Protluced ID Protluced ID
FORM OF IDENTIFICATION � FOR F IDEMIFICATION
_Personally Known _Pereon ly K o
Sipnature of Notary Public Sigmture ry ublic I,
��� � � V
Name of Notary, Typed, Printed or Stamped Name of Notary, Typetl, Printed or Stamped
(NOTARY SEAL) (NOTARY SEAL
'!��•. �1ZBEiHBUENO
M1'COIANISSION�HH 3TB1H
'The ferm"IobbyisC spedfically excWdes the following persons: ��•�O�' �������'�
Exped wdnesses wha provitle only SdeMifiq technical or other specialized infortnation or[estimony in pu6lic meetings;any person wha
onty appears as a representaUve oF a neighborhood assodafion without compensation m reimbursemenf for the appeaiance,whether
direct, indirecl Or con6ngent, to express support of or opposition to any item; and any person who only eppears as a represenlative ot
noMfor-profit cammunily based arganization for the pumose of requesting a grant wRhout special compensetion or reimbursement for
the appearence.
Page 4 of 6
. . �e — A ,." � i
Ciry d Miami Mxh�I]W Cnnrontion Cmror DrNe,Mimni Beoch,Flanda 33139,www.mlomlbeachA.gw
Olfice oNhe CiyCled
Rohd E Gm�wda,Ciy Clerk CiryClerk@miomibeachA.gov
Tel:305.673 7411,Fa�:305.673.7254
NAME OF LOBBYIST: Ralph Choeff
7) L088YIST FEE EXPENDITURE AND COMPENSATION STATEMENT
Pursuant to City Code Section 2-485(d), [he Ciry Clerk shall notify any lobbyist (or
principal)who fails to (ile timely a Lobbyist Fee Expenditure and Compensation Statement
(Statement). In addition to any other penalties that may be imposed as provided in
Section 2-085.1, a fine of $50.00 a day shall be assessed for Statements filed after the
due date. The City Clerk shall notity the Miami-Dade Counry Commission on Ethics and
Pu61ic Trust of the failure of a lobbyist (or principal) to file the Statement or pay the
assessed fines aRer notification.
Any lobbyist, who fails to file the required Statement by April 30'" of each year, shall be
automatically suspendetl 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 calendar year with regard to the specifc 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 Wthdrewal with the Office oi the Cdy Clerk.
3) ANNUAL LOBBYIST REGISTRATION FEE
I understand annual registration of all lobbyists shall be required for each 12-month period
commencing Oc[ober 1 of each year, and lhe fee for such annual registration shall be
$500.00 ursuant to Section 2-482 of the Miami Beach Ciry Code.
� 1
, ^ I � I 'ti
Signature o Lobbyis �ate
f CLER�fFLLYfOqx540Wn5i FORNSLLo[q+M PayWalkn 4nrm Perlaq 411�MREG mc
Page 5 of 5
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Miscellaneous Cash Receipt "
CITY OF MIAMI BEACH No, 433025
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Address
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MBF
Miscellaneous-MCR-2024
006740-0007 Adrian V... 02113/2024 Cq:47AM
MCR oaeN cMCR) Office of Finance Director
Payment Amoum' 1,050 00
(THIS INFORMATION MUST BE COMPLETED) By
Account number. � � � �
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