Steven Weisman/Apety Group Inc.
~
MIAMIBEACH
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 dedsion of any commissioner; any action, dedsion, recommendation of the
City Manager or any dty 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 spedfically indudes the principal as well as any employee engaged
in lobbying activities. The term "Lobbyists" has specific exclusions. Please refer to Ordinance 2004-3435.
UJ& l SAA AA/
NAME OF LOBBYIST: (Last)
STEvcA./
(First)
~ \rc;' c.-
umber and Street) (City)
e Be~e ~I,-,~
FAX NUMBER: C{ t Lf
J:...l, S-, ~- 0 0 ~ I
(M.I)
(State)
(Zip Code)
1--1- q II ~~jcr If' Be ~
3300r
Lv ~(~~4&1 S e
h "n-z."H - c." k.., P<ll?,(' S , (olt)
q~() e-" ~
TELEPHONE NUMBER: q '} L1
4 s-, - 1 q 0 ()
I. LOBBYIST RETAINED BY:
A 2 (~~ C-. ''o) \~"..
NAME OF NCIPAL/C ENT:
I )v.r
331~1
6 d S - ~ a (- 1/ Lf 4
TELEPHONE NUMBER:
'~O('- ~q)"" _ JILl q
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:
c.... Lvc-
13 ~ J1 5 C< 1 f rV""~s
· IDENTIFY ALL PERSONS HOLDING, DIREcrL Y OR INDIREcrL Y, A 5% OR MORE OWNERSHIP INTEREST IN SUCH
CO~PORATION, P-\RTNERSHIP OR TRUST:
/~ ~ SL S 'hV~ S+FY\.IkkS 5..AnL I () 0 ?o
II. SPECIFIC LOBBY ISSUE:
) c.
""' 0 Vt.c -+'r OVl
CITY AGENCIES/INDMDUALS TO BE LOBBIED:
v--~/YOIII~
m.
A) Full Name of Individual/Title
B) Any Financial, Familial or Professional Relationship
e.. .
ft ~a R Y
'..... ,fl
IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WHETHER HOlJRL Y,.
FLATRATEOROTHER): . ~ too ,,00. Sey V) CQ ; YLCI ",d..,J
A) LOBBYIST DISCLOSURE: (Requi~) F-/4 -t R <(...\- ! , '"' 0 V{\rO(, I f v-dj <?rt .f llC.
B) PRINCIPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION): ,(Required). J:= I t( ~ fl C( ~(
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":
2) Pursuant to Miami Beach City Code 2-490 Entitled "Prohibited Campaign Contributions By Lobbyists On Real
Estate Development Issues":
DYes ~o: Are YOU lobbyinG on a DendinG aDDlication for a DeyeloDment AGreement with the City or
aDDlication for chanGe of zonina maD desiGnation or chanGe to the City's Future Land Use
MaD?
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 2-481 above) who only appears as a representative of a not-for-profit
corpor~tion or entity without special compensation or reimbursement for the appearance, 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..
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 PRECEDING CALENDAR YEAR. A STATEMENT
SHALL BE FILED EVEN IF THERE HAVE BEEN NO EXPENDITURE OR COMPENSATION DURING THE
REPORTING PERIOD.
I do solemnly swear that all of the foregoing facts are true and correct and that I have read or am
familiar with the provisions con ain in Section 2-482 of the Miami Beach City Code and all reporting
requirements.
Signature of Lobbyist:
Signature of Principal/Client:
VI. LOBBYIST IDENTIFICATION:
o Produced 10
Form of Identification
o Produced 10
Form of Identification
State of Florida, County of Miami-Dade
Sworn a r}dA'ubscri fore e ~
This~dayot: ~01""~
Signature of Public N ry - State Florida
Notarization of Principal's signature
<: CUll')Ou
Qcu ~C;S
~ ~ ~Nd'
....:l c..s ~ ..U
~ ::r: 0 '" M
t%..cuo~~
oc:~~c::
~~ s~~
~ c..s'r;) .~
~ tI) V,l .. c::
U tI)'s Vol i'll
:3 QJ 8.t ~
~~8~~
~:t~
o c::
Z ~
<: CUll')Ou
Q cu 0\,-..1 .s
;:z ~ r::: ~ :'
9 ~ ~ ..8 VII. SIGNATURE AND STAMP OF NOTARY:
~ ~ 0 1.0 I'Xl
t%.. cu Q ~ .5
~ ~ ~ z] State of Florida, County of Miami-Dade
~ <: s;S; ~ Sworn to a d subscri ed before me
t? ~.~ .. .~= This day of 20~"
u V,).~ Vol
cu ~
::3 ~ ._ <
~:t :>8 ~ ~ Signature of blic Nota - State of Florida
~ ~ Notarization of LobbYIst's signature
o c::
Z
Annual Registration fee: ] Yes [ ] No Amount P .
lobbyist Registration Form received and verified by:
F: \ClER\$ALl \MARIA-M\lobbyist\LOBBYIST fORM
rr- Personally known (Lobbyist)
~sonally known (Principal)
K'S USE ON~~R# 28'3136 Dale Paid3/ 2:1 ~
Revised 12/08/04