HomeMy WebLinkAboutHans J. Krause / The Palms
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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.
30:) '1of
FAX NUMBER:
/-IA/ooJ)
(First)
4v<::r ,...,(J
(City)
3 3S-~
.J
NAME OF LOBBYIST:
I,re f4 /'7 > s..6 .
BUSINESS NAME AND ADDRESS
]V;" 90il J3sy
TELEPHONE NUMBER:
/</l,4J~t5
(Last)
3002.,( Col/',,>
(Number and Street)
(M.!)
Fe. 331Yo
(State) (Zip Code)
/.,)4-:>;,-rI'/J.JJF;) 1-101"4'< .
EMAIL:
t"V')
I.
LOBBYIST RETAINED BY:
TI+E.
PA-~M5
'50 u.. 17-1- 8 t3 Ac.!.! I If\! c... .
NAME OF PRINCIPAL/CLIENT:
BUSINESS NAME AND ADDRESS
-
30 S ~ ') ~ t./ ~~ 5""0 ~
TELEPHONE NUMBER:
30 J 6'" (00;1;... r tJv R K.u.~ ) H /v. WI i &p--4 [p-- '3? NO
(Number and Street) (City) (State) (Zip Code)
FAX NUMBER: (Optional)
EMAlL: (Optional)
Fill out this section If principal is a Corporation, Partnership or Trust [Section 2-482 (c)l
. NAME OF CHIEF OFFICER, PARTNER, OR BENEFICIARY: r--h. K 5 J ~ fA.. vi.. i "-t !c r- Ii-. u...t c.....
. IDENTIFY ALL PERSONS HOLDING, DIRECTLY OR INDIRECTLY, A S% OR MORE OWNERSHIP INTEREST IN SUCH
CORPORATION, PARTNERSHIP OR TRUST: !-ht..1'\"" J () A. d.. ; ^'\ Ie (t 6-. u.. S. L
t..L ys u... (e-- J1 fA. V'L &\. Ie /I....a... '-'-oS c....
SPECIFIC LOBBY ISSUE: e.-o n')1r~d1 W\ % ~~ / ,..e.p....<Jv&<.;:f../~ t..-.-.Il-
~/.. j,'oy\ /tit" ~[Jf2 I$SUeS li../(cLt~v, fie !~t~
Issue to be lobbied (Describe in detail): *" ...... ~ (.r-.P~
IItr.V(;lv,~ P~~.t (J.t~
II.
III.
CITY AGENCIES/INDMDUALS TO BE LOBBIED:
A) Full Name of Individual/Title
B) Any Financial, Familial or Professional Relationship
AJUI'\..--C...
NFYI e..
<l &4. r.t ~ 4.-
C ~ 1t--A
.v~
IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WHETHER HOURL Y,
FLATRATEOR OTHER):
A) LOBBYIST DISCLOSURE: (Required) NONE) ro-(ltftZ.- rrHt1rJ rJq(2;nAL- 6IVlPG"tJ.J/iTf O,J
B) PRINCIPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION): (Required). jJOtJ {;, c>T4Erz '7f+A-AJ AJoiZl11 AL
o ty1. f'ENSr'lT I d A/
i . or
1)
Yes Q
2)
Yes ~
V.
Pursuant to Ordinance No. 2003-3393 Amendina Miami Beach Otv Code Olaoter 2. Artide VII. Division 5
Thereof Entitled "Camoaian Anance Reform" Via The Addition Of Code Section 2-488 Entitled "Prohibited
Camoaian Contributions Bv Lobbyists On Procurement Issues":
Are YOU lobbYinG on a oresent or oendinG bid for Goods, eauioment or services. or on a oresent
or DendinG award for Goods. eauioment or service?
Pursuant to Ordinance No. 2003-3395 Amendina Miami Beach Otv Code Chaoter 2. Artide VII Division 5
thereof Entitled "Camoaign Anance Reform", Via The Addition Of Code Section 2-490 Entitled "Prohibited
Camoaign Contributions By Lobbyists On Real Estate Develooment Issues":
Are YOU lobbYinG on a oendinG aDDlication for a DeveIDDment AGreement with the aN or
aoollcation for chanGe of zonlna mao desianatlon or chanae to the CitY's Future Land Use Mao?
SIGNATURE UNDER OATH:
ON OCTOBER 1 sr OF EACH YEAR, EACH LOBBYIST SHALL SUBMIT TO THE CITY CLERK A SIGNED
SfATEMENT UNDER OATH, LISTING LOBBYING EXPENDnuRES, AS WELL AS COMPENSATION
RECEIVED, IN THE CITY OF MIAMI BEACH FOR THE PRECEDING NDAR YEAR. A SfATEMENT
SHALL BE FILED EVEN IF THERE HAVE BEEN NO EXPENDnuRES COMPENSATION DURING THE
REPORTING PERIOD.
I do solemnly swear that all of the foregoing facts are true and
familiar with the provisions contained in Section 2-482 of the Mia
requirements.
and that I have read or am
ch City Code and all reporting
Signature of Lobbyist:
Signature of Principal/aient:
VI. LOBBYIST IDENTIFICATION:
o Produced ID
o Produced ID
Form of Identification
"Personally known (Principal)
Foml of Identification
{'personally known (Lobbyist)
vu. SIGNATURE AND Sf AMP OF NOTARY:
State of Florida, County of Miami-Dade
Swom to and subscribed before me . "IF-
This Sf..... y OCTO 20.br
State of Aorida, County of Miami-Dade
Swom and subscri before me
This ~day 20l!f-
b' Notary - State of Aorida
Lobbyist's s1gnab.lre
\ JEAN VILLAMlZAR
'E Notary rutile - Stale rK FlOrida
My Cemrn ssioe E>:pi-es May 24, 211115
ComMi..,on . 00029019
\\,11111",
......~,.e,v P;'f/",
l"m~ 'n, JEAN VILLAMIZAR
~. . :.~ Notary Public - State of Florida
'~~ff:"'~-- My Ccmmwo1 ExvnlS Mav24 211115
....",,?f,[,\i'\~~ Ccr'lrr:I~S;Cr'1# ODO'29019
Annual Registration fee: [~ l NO Am nt I
Lobbyist Registration Form received and verified by:
Revised 02/10/04 F:
, USE ONLY 1:2 R2.f<!r. '"" I...:: J ^. {
. MCR # ,/, Date Paid ~
-M\LOBBYIST\LOBBYIST FORM 04