Steven J. Tebon
~fi"",,~
l.,!.1I
'IUr
2UIl3
to
-
-
City of Miami Beach Office of the City Clerk
1700 Convention Center Drive, Miami Beach, FL 33139
LOBBYIST REGISTRATION FORM
LobbyIst: means aU persons employed or retained, whether paid or not, by a prlndpal who seeIcs to encourage the passage, defeat
or modlftc:atlon of any ordinance, resolutlOn, action or decision of any (QITIlllISsIone; any action, dedslon, recommendatlon of the
CIty Manager or any city board or commtttee; or any action, decision or recommendation of any city personnel defined In any
manner In this section, during the time period of the entire decislon-maklng process on such action, dedslon or recommendation
thai: foreseeabIy will be heard or reviewed by the city commls5Ion, or a city board or cornmltl:ee. The term spedtk:ally Includes the
principal as well as any employee engaged In lobbying ad:MIleS. The tIInn .Lobbt..... hlIs spedftc udll*ln.. PI.- refer
to 0rcII1IlIllCe 2004-3435.
\e-horl ,L)'Te,?X"\ -::s-'
NAME OF LOBBYIST: (Last) (Arst) . (M.I)
8xd 1'1", hiF ,~\ -h ~ /"1 \' ~ lr>hO t-\ [')\\/1 ",rl \)1" .~ ?-l L :"?rc;;:Ka:t nn. FI 334'i?:7.
BUSINESS NAME AND DRESS (N street) (CIty) (State) '(Zlp Code)
<::;(/)/- ZeN ~g()1
TELEPHONE NUMBER:
{::;;{(') {. '2 L{ f . .3 f)O:S
FAX NUMBER:
~~ F';lCe \L.)"31 ue's?om .Com.
EMAlL:
I. LOBBYIST RlTAlNED BY:
~~'P\'rPV\ ~P\r'C)",
NAME OF PlUNOPAl./CUENT:
r;J<r:lcY;/ve.~~ \.(",kPli""l' If't,{'') 1-\"\\ll~b31"'?'l ~~o~\='( 3?>4n
BUSINESS NAME NO ADDRESS ~umber and street} (CIty) () (ZIp Code)
""itn\ - ZL\ \ ,")'?,CJ\ ."'5lol- z q ,- 3goS ~~ rPk,,~"(,lt"svot-'\s- CO\')').
TElEPHONE NUMBER: FAX NUMBER: (Optional) EMAIL: (OptIonal)
flU out this section If prindpal is a Corporation, Partnership or Trust [SectIon 2-482 (e)]
. NAME OF CHIEF OFFICER, PARTNER, OR BENEFICIARY:
5'"\evC'll ~e'Con
. IDENTIFY ALL PERSONS HOLDING, DIRECTLY OR INDIRECTLY, A 5% OR MORE OWNERSHIP INTEREST IN SUCH
CORPORATION, PARTNERSHIP OR TRUST:
~ie.\}ex-'\ "\e '00'"
II. SPECIFIC LOBBY ISSUE:
~Fr{nl f'\kY\-t (',('n,\,\'1 ~\icn::hon)-C..,r ~e WiCcWll' Keetch S,..pl~r~n5
to be Iobbled (Desalbe In detail): &nco s
III. CITY AGENCIES/INDMDUALS TO BE LOBBIED:
A) Full Name of Indlvidual/Tltle
B) Any FInancial, Familial or Pl~ional Relationship
33\ :l.:l(:) S.WJj
G3^i383M
.
IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYlST COMPENSAnON (DISCLOSE WHETHER HOURL Y,
FLAT RATE OR OTHER):
A) LOBBYlST DISCLOSURE: (Required) N J A .- 0-
B) PRINCIPAl'S DISClOSURE (OF LOBBYIST COMPENSA11ON): (Required). N I A . ..... 0,...
V_ ~ Are VOU _ u......__ a nat-for-DI'Oftt amIDI'IItion or entitv without _lA' ~ or
reIm~ Pursuant to Ordinance No. 1004-3435.
1)
~E=-=:- :3393 Amendino Miami Beach Cltv Code Chaob!r 2. ~ vn. Divtsion 5
Refonnw VIa The Addition Of Code c:..rlitv\ 2-488 Entitled ~Prohlbited
Carnpalan ContrIbutions By I ~ On Pnxurement t....uP.S":
v_ ~) Are VGU IGbbvlna on . DI --. or D8lWllna bid for ftfVW'I. ..ullIIII8ftt or......... or an 8 ..-.nt
or MndIna IIWIIrd for....... .............. or ....w:e?
2)
="~1~==~3395 Amendlno Miami Beaq1 Cltv Code ChaDleI' 2. Article vn DIvIsion 5
~. Refonn". Via The AddItIon Of Code <;Minn 2-490 Entitled "Prohibited
Carnpaian C.ontributions BY Lnbbvlsts On Real Fc:tRtP Development Issues":
v.
SlGNATURf! UNDlR OATH:
and that I have read or am
City COde and all reporting
ON OCTOBER 1ST OF EACH YEAR, EAat LOBBYIST
5fATEMENT UNDER OATH, LJSrlNG LOBBYING
RECEIVED, IN THE arv OF MIAMI BEAat FOR TH
SHALL BE FILED EVEN IF THERE HAVE BEEN NO
REPORrING PERIOD.
I do solemnly swear that all
familiar with the provision
requirements.
Signature of Lobbyist:
SIgnature of PrIncipal/alent:
VI.
PRlNCPAL IDENTIFlCAnON:
D Produced 10
-
_ .5kW\e
D Produced 10
Fann rI Identification
J15. Personally known (LobbyIst)
VB. SIGNATURE AND 5fANP OF NOTARV:
Fonn fA Identification
D Personally known (Principal)
State rI RorIda, County rI Mlaml-Dade
Sworn to and subsalbed before me
This I (P day rI \:)ece<<\'t:ff20!ij
~-Staterl FlorIda
Nubtolutlollft of Lobbyist'11Ignature
-.-.D...".....~~:~::l
. . Explm ,ncw2OO1
~tJF IlondecI thnluDII
(aoo-m~2541 FloIkla Nolll/y . lllo.
--..
State rI Florida, County rI Miami-Dade
SWorn and subscribed before me
This _day rI . 20_
Signature rI Public Notary - State rI Rorida
Not8rIzatIon of Princlper. signature
~~ ~13t3lj Date Paid
Annual Registration fee: [ Yes [ ] No
lobbyiSt Registration Form received and verified by:
Revised 02/10/04 F'