Michael Larkin/ William Goldsmi
From: 3053776222
Page: 2/5
Date: 1/21/20051:36:48 PM
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....
City of Miami Beach Office of the City Clerk
1700 Convention Center Drive, Miami Beach, FL 33139
LOBBYIST RlCGISTRA nON FORM
Lobbyi$t means all persons employed or retained, whetl1er paid or not, by a prinCipal who seeks to encourage the
passage, defeat or modification' of any ordinance, resolu~on, action or decision of any commiSSioner; any action, decision,
recommendation of the Qty Manager or any city board or committee; or any odIon, decision or ri!cbmmendatlon of any
city persOnnel defined in any manner in this sectlon, during the time period of the entire decision-making process on such
action, decision or recommendation that foreseeably will be heard or reviewed by the City commission, Or a city board or
committee. The term specifically Includes the principal as welf as any employee engaged in lobbying activities_ The tenn
~Lobbyi~ts" has specific exclusions. P1llase refer tD Ordinance 2004-3435.
NAME OF LOBElYlST:
Larkin
( Last)
Michael
(RISt)
W
(M.I)
200 S. Biscavne Boulevard
BUSIN~SS NAME AND ADDRESS (Number and Street)
Miami
(City)
Florida 33131
(State) (ZIp Code)
(305) 377-6231
TELEPHONE NUMBER:
()051 377-6222
FAX NUMBER:
EMAIL:
1. LOBBYIST RETAINED BY:
William Goldsmith
NAME OF PRINCIPAL/CLIENT:
1B20 W. 25th Street. Sunset Island No.2
BUSINESS NAME AND ADDRESS (Number and Street)
Miami Beach
(City)
Florida 33140
(state) (Zip Code)
tELEPHONE NUMBER:
FAX NUMBER: (Optional)
EMAIL: (OptIonal) ,
Fill out thl$ section If prIncipal is a Corporation, Partnership or Tru$l; [Sec.tlon 2-482 (c)]
. NAME OF CHIEF OFFICER, PARTNER, OR E1,Ei')IEFICIARY:
.lOENTIFY ALL PERSONS HOLDING, DIRECTLY OR INDIRECTLY, A 5% DR MORE OWNERSHIP INTEREST
IN SUCH CORPORATION, PARTNERSHIP OR TRUST:
II. SPECIFIC LOBBY ISSUI:::
Lot Split AQDllcation for Properties located at 2500 Bav Avenue and 1820 West 25th Street. Sunset
Island No.2. Miami Beach. Florida 33140
Issue to be lobbied (Describe In detail):
III. CITY AGENCIES/INDMDUALS TO BE LObBIED:
A) Full Namll of IndlvldualjTltle B) Anv Financial, Familial or Professional
Rl!latlonship
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From: 3053776222
Page: 3/5
Date: 1/21/20051:36:48 PM
IV. DISCLOSURE OF TERMS1l.ND AMOUNTS OF LOBBYIST COMPENSATION (b:d;ClOSE WHITHER HOURLY,
FLAT RATE OR OTHER):
A) LOBBYIST DISCLOSURE; (Required). $300.00
B) PRINCIPAL'S DISD-OSURE (OF lOBBYIST COMPENSATION); (Required). $300.00
lIll Y@~ No' An> YOU ....aresentlna a not-far-orafit cora oration or entitY without soedal comDensat;on Or
relmbul:5Bment. Pursuant In Ordina.- No. 2004"~
1)
Pursuant to ,Ordinance No. 2003-3393 Amendina Mlan;i, Beach CI~ ~~~~~aot~ 2En~~i~e ~~~~~~n 5
Thereof entitled 'Camn1lran Finance Reform" V,a The -'idd,t,on Of Co e 2-4 8 II' I
CamoalQn Contrfbutinns Bv Lobbvists On Procurement Issues"'
lIII YesA(NO: Are you 10bbYina on a o_nt or oendlna bid for Doods. eauloment or services. or on a oresent
- d . ?
or Den [no award for oOOOs. l!OUlllment Or service
2)
fursuanl to Ordinance No. 2003-33!lS Amendina Miami Beach Otv ,=;~~ot~ 2.;~cle V1~~I~n 5
thereof En~tled "Camcaion Finance Reform" Via The AddlMn Of Cede "1 0 . ed'p I' d
~moalan Contributions Bv Lobbyl~ On Real Estate ~IODment Issues":
IYO!S~o: Are y~u lobbving on a D"'n~lno aDDlicatlon for a oevelollm:::ea~~:,~e;~ ~~~ ~~~~:~
aDDlication far chanae of zonIng maD dl!Slgnatlon or chano~ . t aQl
V. SIGNATURE UNDER OATH:
ON OCTOBER 1ST OF EACH YEAIt, EACH LOBBYIST SHALL SUIIMrT 1'0 THE crrv CLERK A SIGNED
STATEMENT UNbER OATIi, LISTING LOBBYING EXPENDITURES, AS WELL AS COMPENSAT10N RECEIVED,
IN THE CITY OF MIAMI BEACH FOR THE PR.t:CEDING CALENDAR. YEAR. A STATEMENT SHAU BE FILED
EVEN IF THERE HAVE BEEN NO EXPENDITURES OR COMPENSATION DURING THE REPORTING PERIOD.
~~~
Signature of lobbyist
I do solemnly swear that all of the foregoirlg facts are true and correct and that I have read Or
am familiar wIth the provisiOns contained In SectIon 2-482 of the Miami Beach City Code and all
reporting requirements.
Signature of Lobbyist:
Signature of PJincipal/Client:
~0~
~
VI. LOBBYIST IDENTIFICATION: PRINCIPAL IDENTIFICAnON:
il Produced ID n Produced ID )l.\.p1...S LIC-P'V> S.
Form of Identification Form of
-.,L\ G) MARTIN O. STELLING
FrSOnally known (LObbyist) 0 Personally known CPri" P MY COMMISSION # 00067603
EXPIRES: November 27. 200'
VII, SIGNATURE AND STAMP OF NOTARY: l-a00.3-NOTARY FLNowy_&Boncling,'nc
State of Florida, County of Miami-Dade
SWorn to d subscribed lJef'Y':. e 0<--
This ,da o~ l)~" ~~
FOR CLERK'S USE ONLY
A~nual Registration fee: [] Yes t.~Amount Paid $? ,-, (.~ #.P 73 ;r,'iji- Date Paid ,:) / U/Lr:.-
Lobbvl>t Registration Form received and verifled by:
Revised 02{10{04 F: CLER\AlL\ lA-M\LOBSYIST\LOBBYIST FORM [)4
, Flrsl Revision -05-17-02
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