Yorke Rhodes/IBM Corp. MIAM,! BEACH
·
City of Miami Beach Office of the City Clerk
1700 ConYention .Center Drive, Miami Beach, FI_ 33139
LOBBYIST RE'GISTRATION 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 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.
Rhodes ¥orge.
NAME OF LOBBYIST: (Last) (First) (M.I)
BUSINESS" NAME AND ADDRESS
TELEPHONE NUMBER:
(Number and Street) (City) (State) (Zip Code)
FAX NUMBER: EMAIL:
I. LOBBYIST RETAINED BY:
NAME OF PRINCIPAL/CLIENT:
BUSINESS NAME AND ADDRESS
Bo~' ~/~,, ~ 530
(Number and Street) (City)
(State) (Zip Code)
TELEPHONE NUMBER:
FAX NUMBER: (Optional)
EMAIL: (Optional)
Fill out this section if principal is a Corporation, Partnership or Trust [Section 2-482 (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:
SPECIFIC LOBBY ISSUE:
Issue to be lobbied (Describe in detail):
[V. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WHETHER ~'iOI./RI. ~
A) LOBBYIST D[$CLOSURE: (Required) ~10~t~
13) PRZNC[PAL'S DISCLOSURE (OF LOBBY[ST COHPENSA'rZON): (Required). ~; ~ [ O1~'v
The following information must be answered:
1)
Pursuant to Miami Beach City Code Section 2-488 Entitled "Prohibited Campaign Contributions By Lobbyists
On Procurement Issues":
[] Yes E~Io: Are you IobbvinQ on a ore~ent or oendinQ bid for eoods, eeuiament or services, Qr 0n --
oresent or oendin= award for =oods, eeuioment or service?
2)
Pursuant to Miami Beach City Code 2-490 Entitled "Prohibited Campaign Contributions By Lobbyists On Real
Estate Development Issues":
[]Yes C~lo: Are you Iobbvin= on a DendinQ aonlication for a DeveloDment Aerccme.,n.t with the City oi'
~ a_oolication for chanae'Of zon~na-maO desiQnati0n 0r chan~e to the City s Future Land-Usc
Ma_o?
3) Pursuant to Miami Beach City Code 2-484 (h) Any person (except those exempt from the definition 'of
"lobbyist" as set forth in Section 2-48:[ above) who only appears as a representative of a not-for-profit
corporation or entity without special compensation or reimbursement, for the app.eara..nce, Whether direct, or
indirect, to express support of or opposition to any item, shall register 'with the clerk as required by this
section but, shall not be required to pay any registration fees..
[] Yes So: Are you reoresentin~ a not-for-profit corooration or entity without soecial comoensation
or reimbursement, .
,~ ,
V. SIGNATURE UNDER OATH:
ON OCTOBER IsT OF. EACH YEAR, EACH LOBBYIST SHALL SUBMZT TO THE CZTY CLERK A STGNED
~TATEMENT UNDER OATH, LT~TZNG' LOBBYTNG .EXPENDZTURES, AS~ WELL;AS COMP~NSATZON
RECEZVED~ TN THE C]TY OF MZAMT BEACH FOR THE PRECEDTNG CALENDAR YEAR. A STATEMENT
SHALL BE FZLED EVEN ~F THERE HAVE BEEN NO EXPENDITURES OR COMPENSAT~O~ ,DUPING THE
REPORI'LNG PER]OD. ~ / _(/,~
I do solemnly swear that all of the foregoing faClrs are true a ct and that I have rea 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 Principal/Client: ~
VI. LOBBYZST IDENTZFICATION:.~,)~/. ,~/~o ~c/~" -/g~, PRINCIPAL IDENTIFICATION:
Form of ]:d~nti~ti~n
Form of Identification
r_:} Personally known (Lobbyist) E] Personally known (Pr~t.~ -- -- ~ ;/14~-- .~-~
&.-~\N~ ~.mc- ~ ~ F~,~[
V/X. SXGNATURE AND STAM~ J~F~IQ,TAJ~Y~ ......... /t'..E
State of Florida, County of Miami-D]~~Nolmy t'.t:~. ~~i~a, County
Sworn to~ and subscrib~;;~ before m~l~'~ ~'~¥;~.--'-~;~r~b~:ribed ~f~,'o-~e--
This ~/~ day of ~~,, ~~~C~.mli~ # i~.'~c~'; of ~'PO
S~gnature of Public Notar~- State of Florida Signature(o~blic Notary - State o~"FIorida
Notarization of Lobbyist'$?ig.,nature ~ ~ Notarization of Prindpars signature
'~-'-* '1"" ¢"; ~
FOR CLERK'S USE ONLY -
^.nua~R~g~straUonr~: [ ]Y~s[ ]No AmountPa~d ~'~ .CR#~IOI~ Date.aid
Lobbyist Regisb'aLion Form received and verified by: ~c:%_.~_~ ' '
F:\CLER\$ALL\IVlAR]A-M\Lobbyist\LO Y[ST fORM 05."0~c Revised 12/08/04