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Robbins Kent/Anthony S Brown "1,:"", HI' ;u.11 m bIb:t - - '~p WU3 - 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. ~oo NAME OF LOBBYIST: (Last) l2ZLl BUSINESS NAME AND ADDRESS 3D5 '5~2" () SOO TELEPHONE NUMBfR: Kent (First) +tar r(/X) n (M .I) .F; 331 (State) (Zip Code) /(hrcbb e, pell south. ~ EMAlL: I. LOBBYIST RETAINED BY: NAME~~~~LJC~N~: ~OW{l I man~~f LLC Co/If (City) TELEPHONE NUMBER: FAX NUMBER: (Optional) EMAIL: (Optional) Fill out this section if principal is a Corporation, Parb1ership or Trust [Section 2-482 (c)] . NAME OF CHIEF OFFICER, PARTNER, OR BENEFICIARY: Anthon y S:~rcttfl j manc~~r I\~ IY\...ln ~ . IDENTIFY ALL PERSONS HOLDING, DIRECTLY OR INDIRECTLY, A SOlo OR MORE OWNERSHIP INTEREST IN SUCH CORPORATION, PARTNERSHIP OR TRUST: 'See. -A~ S~4 II. SPECIFIC LOBBY ISSUE: t';k.\: nolOl1 0 ~ it in e h." tOIL 'l\~cs lq t'\ kbt ll.uJ 1:3ooro{ Issue to be lobbied (Describe in detail): ~ U III. CITY AGENCIES/INDMDUALS TO BE LOBBIED: A) Full Name of IndiVidual/Title B) Any Financial, Familial or Professional Relationship 8CA rd 5~(~ NOik No~ . IV. . DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WHETHER HOURL Y, FLAT RA TE OR OTHER). A) LOBBYIST DISCLOSURE: (Required) hcMV B) PRINCIPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION: (Required). ~ CfCl) h LA. Y D Yes ~o: Are YOU reDresentinG a not-for-Drofit corDOration or entity without soecial comoensation or reimbursement. Pursuant to Ordinance No. 2004-3435. 1) Pursuant to Ordinance No. 2003-3393 Amendina Miami Beach City Code Chaoter 2. Article VII. Division 5 Thereof Entitled "Camoaiqn Finance Reformn Via The Addition Of Code Section 2-488 Entitled "Prohibited Camoaian Contributions Bv Lobbvists On Procurement Issuesn: D Yes ~: Are YOU lobbyinG on a Dresent or oendinG bid for GOods. eaulDment or services. or on a oresent or oendinG award for qoods. eauioment or service? 2) Pursuant to Ordinance No. 2003-3395 Amendina Miami Beach City Code Chaoter 2. Article VII Division 5 thereof Entitled "CamDaign Finance Reform", Via The Addition Of Code Section 2-490 Entitled "Prohibited Camoaian Contributions By Lobbvists On Real Estate DeyeloDment Issues"; DYes ~: Are you lobbyinq on a oendinG aoolication for a Deyelooment AGreement with the City or aDDlication for chanGe of zoninG maD desianation or chanGe to the City's Future Land Use MaD? 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 PREC NG CALENDAR R. A STATEMENT SHALL BE FILED EVEN IF THERE HAVE BEEN NO E RES COMe ON DURING THE REPORTING PERIOD. Signature of Lobbyist: Signature of Principal/Client: VI. rrect and that I have read or am Beach City Code and all reporting o Produced 10 PRINCIPAL IDENTIFICATION: MroduCed 10 FUJ,(/j)# {),RIV~ LtC to 0 Form of Identification Form of Identification XpersonallY known (Lobbyist) VII. SIGNATURE AND STAMP OF NOTARY: o Personally known (Principal) State of Florida, County of Miami-Dade Sworn and subscribed before me This ..L.2:.-day of MLIt.. , 20~ Annual Registration fee: Yes [ ] No Lobbyist Registration Form received and verified Revised 02/10/04 E ON~R #;27'~7 PERSONS HOLDING, DIRECTLY OR INDIRECTLY, A 5% OR MORE OWNERSHIP INTEREST IN MIAMI BEACH HOTEL INVESTORS LLC: Anthony S. Brown Frank DeLeonardo Steve Carlson Sharon Brown ./