Aleksandar Stojanovic
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City of Miami Beach Office of the City Clerk
1700 Convention Center Drive, Miami Beach, FL 33139
LOBBYIST REGISTRATION FORM
Lobbyist means all persons employed or retained, whether paid or not, by a principal who seeks to encourage the passage, defeat
or modification of any ordinance, resolution, action or decision of any commissioner; any action, decision, recommendation of the
City Manager or any city board or committee; or any action, decision or recommendation of any city personnel defined in any
manner in this section, during the time period of the entire decision-making process on such action, decision or recommendation
that foreseeably will be heard or reviewed by the city commission, or a city board or committee. The term specifically includes the
principal as well as any employee engaged in lobbying activities. The term "Lobbyists" has specific exclusions. Please refer
to Ordinance 2004-3435.
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NAME OF LOBBYIST: (Last)
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(First) (M.I)
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(Number and Street) (City) (State) (Zip Code)
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FAX NUMBER: EMAIL:
BUSINESS NAME AND ADDRESS
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TELEPHONE NUMBER:
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LOBBYIST RETAINED BY:
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NAME OF PRINCIPAl/CLIENT:
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BUSINESS NAME AND ADDRESS (Number and Street) (City)
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TELEPHONE NUMBER: FAX NUMBER: (Optional)
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(State) (Zip Code)
EMAIL: (Optional)
Fill out this section if principal is a Corporation, Partnership or Trust [Section 2-4B2 (c)]
. NAME OF CHIEF OFFICER, PARTNER, OR BENEFICIARY:
. IDENTIFY ALL PERSONS HOLDING, DIRECTLY OR INDIRECTLY, A 5% OR MORE OWNERSHIP INTEREST IN SUCH
CORPORATION, PARTNERSHIP OR TRUST:
II. SPECIFIC LOBBY ISSUE:
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Issue to be lobbied (Describe in detail):
III. CITY AGENCIES/INDIVIDUALS TO BE LOBBIED:
A) Full Name of Individual/Title
B) Any Financial, Familial or Professional Relationship
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IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WHETHER HQURL Y,
FLAT RATE OR OTHER): It.. 1 ,.-
A) LOBBYIST DISCLOSURE: (Required) ~Vv t;
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Yes
1)
Pursuant to Ordinance No. 2003-3393 Amendina Miami Beach Citv Code Chaoter 2. Article VII. Division 5
Thereof Entitled "Campaian Finance Reform" Via The Addition Of Code Section 2-488 Entitled "Pr~hibited
Campaign Contributions Bv Lobbvists On Procurement Issues":
Are YOU 10bbvinG on a Dresent or oendinG ~i~ ~r ~:s. eauiDment or services. or on a Dresent
or oendinG award for Goods. eauiDment or service?
Yes to'
2)
Pursuant to Ordinance No. 2003-3395 Amendina Miami Beach Citv Code Chaoter 2. Article VII Division 5
thereof Entitled "Campaian Finance Reform". Via The Addition Of Code Section 2-490 Entitled "Prohibited
Camoaian Contributions Bv Lobbvists On Real Estate Develooment Issues":
v.
SIGNATURE UNDER OATH:
ON OCTOBER 1ST OF EACH YEAR, EACH LOBBYIST SHALL SUBMIT TO THE CITY CLERK A SIGNED
STATEMENT UNDER OATH, USTING LOBBYING EXPENDITURES, AS WELL AS COMPENSATION
RECEIVED, IN THE CITY OF MIAMI BEACH FOR THE PRECEDING CALENDAR YEAR. A STATEMENT
SHALL BE FILED EVEN IF THERE HAVE BEEN NO EXPENDITURES OR COMPENSATION DURING THE
REPORTING PERIOD. . t ~ ~
X Signature of Lobbyist
I do solemnly swear that all of the foregoing facts are true and correct and that I have read or am
familiar with the proviSions contained in Section 2- of he Miami Beach City Code and all reporting
requirements.
Signature of Lobbyist:
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VI.
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LOBBYIST IDENTIFICATION:
Produced ID rtJ~'$"~d{'btJ0703()go
Form of Identification
PRINCIPAL IDENTIFICATION:
Produced ID
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em 0f Identification
Personally known (Lobbyist)
Personally known (Principal)
VII. SIGNATURE AND STAMP OF NOTARY:
/ FOR CLERK'S USE ONLY /) '} ;) ::2."7 r\
Annual Registration fee: [ ,- ] Yes [ ] No Arno n Paid 1<)0, Iff) MCR ~ ~ate Paid
Lobbyist Registration Form received and verified by: ".
Revised 02/10/04 F: LER L MARIA-M\LOBBYIST\LOBBYIST FORM 04
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