Alexander Tachmes/Sephardic Congregation of Fla, Inc.
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MIAMI BEACH
City of tv1iami Beach Office of the City Clerk
1700 Convention Center Drive, tv1iami Beach, FL 33139
LOBBYIST REG ISTIU TI O:'{ FOR.\I
LDbtJyi~'t fTleans all oerrotlS (!rnplc~i!u Of re!.ainf!(t .",".'t/ether paid or 'lot ~y Ii pnnciu,al who ~eks to erlL"OOraq:f! tlu,,:! pd~qe. j~f.;!al
C'l Inodl~I(JtK>n 'Of Jr~y of(Hnclv:e, !eselulmfJ. LKtrJ11 cr iji~.)Sion tH i:.:t1,. O"Jmrnl5SICOer;any aC~IOf\ declsron,. r{:((1rnrnendatj.:!r- 01 tf1i;:
City '\~1;~nager or an~ Ot'l O(h3rC {V C(lrrm-;ittee; or aT)' acton, c;ecisiort ,~~ rfcommefldat~Qr, cf 3ny ot\~ D~rsonnel ounng tne tl'TlP
pen(1olj of the +;n:tre deCl:;I(JIl~fnakHHI process 0'1 5uetl BC:lon, deClSF)f) tV recoo1nendaLon r..'lat k.l!esceeal)!v ~'vl!1 t>e tV!.:Hd {)t r~VII':~.t'ed
L\,; Hie city CG/lnhs.:.iN.;..n. or t) tit''!' b~dtd or ':.uI~Hnltt{.;e. 1 ('1<,. hunl ~;J(~UfiGjll':llnUtJtlt!;-, ttlt~ C)rlfl<Jf)d tl:.,,;d' c:1:' drl'~' eJnpi:Jyt:l~ t?f'f/aVllr./
In Iot:b'v1rl.:; .3ctn.'iries, The term "Lobbyists" has spcclfic exclusions. Pleasc rcfcr to Ordinance 2004-3435.
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GUS1NES':, NI"HE N.D ADDRESS
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I, LOBBYIST RETAINED BY:
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~IAI.1E OF PR,NClvAL,iCUErH,
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:jlJ:)IN::S~; ~t~r-if ,A;ND ADDRESS (NLmt,erd'1dFth;et) (City)
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F"X 'JU~mER; (OpliOndl)
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Fill out this section if principal is a Corporation, Partnership or Trust [Section 2-482 (c)] .-
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TDfNTFY:,[I PERSONS 1 "01 O1'IG, rm::fCI Y OR. INDFECT. Y, A 5~,., OR ,"'ORE O\^iNER5I"IP INTER.EST 1'1 SIJOi
COHflORt..TION, PflRl NfRSHIP OR TRUST.
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II, SPECIFIC LOBBY ISSUE':
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CITY AGENCIES/INDIVIDUALS TO BE LOBBIED: n
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B) Any Financial, F,lmilial or Professional Relalion"j\ip :;;
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A) Full Name of Indlvidu;llfTillc
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IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WHETHER HOURL Y,
FLA T RA TE OR OTHER):
A) LOBBYIST DISCLOSURE: (Required)
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B) PRINCIPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION): (Required).
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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":
DYes LAre YOU 10bbyinQ on a oresent or oendinQ bid for Qoods. eQuioment or selVices. or on a
oresent or oendinQ award for Qoods. eQuioment or selVice?
2) Pursuant to Miami Beach City Code 2-490 Entitled "Prohibited Campaign Contributions By Lobbyists On Real
Estate evelopment Issues":
DYes Are YOU 10bbvinQ on a oendinQ aoolication for a Deyelooment AQreement with the City or
aoolication for chanQe of zoninQ mao desiQnation or chanQe to the City's Future Land Use
Mao?
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
corporation 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 1 Sf OF EACH YEAR, EACH LOBBYIST SHALL SUBMIT TO THE CITY CLERK A SIGNED
STATEMENT UNDER OATH, LISTING 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 EXP ITURES 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 co ined in Se . n 2-482 of the Miami Beach City Code and all reporting
requirements.
Signature of Lobbyist:
Signature of Principal/Client:
VI.
LOBBYIST IDENTIFICATION:
PRINCIPAL IDENTIFICATION:
D Produced ID
D Produced ID
Form of Identification
Form of Identification
~SOnaIlY known (Principal)
VII.
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State of Florida, County of Miami-Dade ::: .... : *::
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Sworn and subscri~ before me ~'?I~. #00526581 ':iJ~
This ~da ~e~ , 200'- ~~;'~~~d\l1l\l ~-#..,~~
Y IC.STATE OF FLORIDA ~ %J'~b;~~~~:~'o~~~
. elgado · ~III Ie, ST~~",,"~
Signature of blic Notary - Stat~ rRCbmmission # DD594~ature of Public Notary - State of Florida "","
Notarization of Lobbyist's sigh I......~. Expirt:s: SEP. 11, 2l3'i<<b'=arization of Principal's signature
BO' , .... .
SIGNATURE AND STAMP OF NOTARY:
~rsonally known (Lobbyist)
FOR CLERK'S USE ONLY
Annual Registration fee: [\ LYe!; [ ] No Amount Pqid . f' MCR #
Lobbyist Registration Form rt!Ceived and verified by: If"';:/ ';
F:\CLER\$ALL\MARIA-M\Lobbyist\LOBBYIST fORM OS. doc )J:;.--
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Date Paid
Revised 12/08/04
entued 0-lrl O~