Guido Del Valle/Walgreen Company
lD MIAMIBEACH
.....
City of Miami Beach Office of the City Oerk
1700 ConventiOn Center Drive, Miami Beach, A. 33139
LOBBYIST REGISTRATION FORM
lobbyist means .. persons empIafed or ndalned, whether paid or not. bJ a principal who seeks to encourage the passage, defeat
or rnodifkation C'I any ordinance, n!SOIutlon, action or decision C'I any oAI...lissIoner, any action, decision, IllCOr11l'I1eRd C'I Ute
Cly Manager or any cI:y boIIrd or ........li1bIei or any action, decislon or recommendation of any dty personnel during the time
period of the entire dl.dsloIrll..c11111 process on such action, decision or recon....Gltion tbat foreseeably will be heard or reviewed
bJ the city ............ or a cI:y board or c:urnrmttee. The tI!l'm ...,.diGaIIY Includes the principal as weD as any employee engaged
In lobbying ad:iYIies. 1Ile....~...spedftc ...IirR 1 .T................ 0........ ZG04-3435.
17.EL YA.LLE. eO} PO
NAME Of lOBIMST- o..stl (first)
1Si:DW,-, d~A-A'O'" A~c'~\~C."t"'7.. At...
c,"t\ 0 ~c.U e,o 4b'r: tt: 10 \41"\\
BUSINESS NAME AND ADDRESS (Number and Street) (Clly)
:pDC;' (,(,-z.. l.:clo ~t7. ~(.-z..l~Z1
TB.EPHONE NUMiER: FAX ~
(M.!)
~~~
(state) (ZIp Code)
u\S&~O ~ ~f.C)" ~Y)r. eo,""
EMAIL:
t=~
L LOBlrdsr AEJ'AINED BY:
W~Lb~~ Cc., rv.s '1.U,IM)U ~!-f'()(LJ<Oo,J
NAME OF PRINClPAl./CUENT:
W~lt.~EJJ ,Co. \0(, W\\J"1()f~. 17~b \L.
BUSINESS NAM: AND ADDRESS (Number and~) (Cily) (StatI=)
'O\\1~~i'S -y.~\O
1B.EPHONE NUMBER:
{POO Ii?
(Zip Code)
FAX NUMBER: (0pIianBl)
EMAIL: (OptIonal)
.. OIII:....lIIIC:IiM If prIIIdpltIls . CDI_oIIIMIr PlI6~"'" 01' 1't'IMt [SecIIaa 2-4G (e))
. NAME Of OIIEF 0f'fICER, PARl'tER. OR BENEfIaARY:
:::ftFf1<E1 NILE 0
. 1DENTIFY AU. PERSONS HOLDlNG, D1RECT1.Y OR lNDIRECT1.Y, A 5% OR MORE OWNERSHIP INTEREST IN SUCH
CORPORATION. PAR1'NERSH1P OR 1RUST:
See ~~eout.t 'i trrrFqt~ ~t <:>
u. SPECJFICLOBBYJSSUE: C;\~N V4it.\~~ f"O'lit. E,~~rt"4 ~'fE!)Jt.;,
C,Toe..E. /::,.'f\ Co 100 CoWtJl;;>> JuJE. 4~ fEt. ~~.~. OIZ.t)IE.fl,.
Issue to be lobbied (DescrIbe In detall):
m. CITY ~/lNDlVIDUAlSTO BE lOBBIED:
A) FIiII_" ~.IJ..I(IIIIe
B),.., RILRR~IIII, ~... P.~...... RehlIIonIIhIp
NONE.
IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WHElltER HOIIRLY,
RATRATEOR011lER): :Y
A) LOBBYIST DISCLOSURE: (RequIred) -iJ 1.. C? Of) ~e- 0 L'rz.. .
8) PRINCIPAL'S DISCLOSURE (OFLOBBYISTCOMPENSATION): (RequIred). ~'11S'.()..) r-etZ-VJ\:)\J,L...
The following infor....tion must be answered:
1) Pl.I"SUCIJlt to Miami Beach Oty COde Section 2-488 Entitled "Prohibited campaign Contributions By Lobbyists
On Procurement Issues":
nv_ \tHo: Are =~"t: .:,::::.t===::iDment or services. or on a
~ Dn!lHI'It or aencI~ard far.aoodL ~imnent or service?
2) PlXSuant to Miami Beach Oty COde 2-490 Entitled "Prohibited campaign Contributions By Lobbyists On Real
Estate Development Issues":
~o: ::.~=:m::e=:::-=.:=~~:==u:.
HBZ
3) Pusuant 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 noHor-profit:
corporation or entity without special compensation or reimbu-sement for the appearance, whether direct, or
Indirect, to express support of or opposition to any item, shall regISter with the derk as required by this
section but, shall not be required to pay any regIstratiOn fees..
~NO: Are you reDus_lina a not-for-arofit coraoration or entitv without soec:ial ClOmaensation
or reimbursement. .
V. SIGNATURE UNDER 0A11t:
ON OCTOBER 1ST OF EACH YEA~ EACH L088Y151' SHAlJ. SUBMIT TO THE CI1Y CLERK A SIGNED
STATEMENT UNDER OATH, USTING LOBBYING EXPE WElJ. AS COMPENSATION
RECEIVED, IN THE. CI1Y OF MIAMI BEACH FOR THE LENDAR YEAR. A STATEMENT
SHAlJ. BE FILED EVEN IF THERE HAVE BEEN NO COMPENSATION DURING THE
REPORTING PERIOD.
I do solemnly swear that all
familiar with the provisions
requirements.
Signature of lobbyist:
Signature of Principal/Cr
VI.
facts are true and correct and that I have read or am
n 2-482 of the Miami Beach City Code and all reporting
u Produced 10
u Produced ID
.ficatioo.~!.~ SEAL
5UlMNI: K CHJNG
) NOTARY PtaIC. STATE OF LLINOIS
tn COtMSSlON EXPIRES:04I09m
Fonn of Identification
G Personally known (Lobbyist)
VII. SIGNATURE AND STAMP OF NOTARY:
Form of I
~Personally known (Prind
J;U.,,-,& "A-~
State of ~;COU1ty of .1iefllj gaee
Swom a~ subscribed before me }
-~ ijay~~
Signature of Public Notary - Sta .'>Ij~(~
Notarization of Principal'. signature
Revised 12/08/04
SCHEDULE 1
Walgreen Co. , an Illinois corporation is a publicly traded company on the
New York Stock Exchange and the NASDAQ. No shareholder holds more
than 10% of the company stock.