Robert S. Wennett/Robert Wennett
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MIAMIBEACH
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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 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 dty 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.
(Last) (First) (M.I)
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BUSINESS NAME AND ADDRESS (Number and Street) (City) (State)
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TELEPHONE NUMBER: , I. C.
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NAME OF PRINCIPAL/CLIENT:
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NAME OF LOBBYIST:
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(Zip Code)
FAX NUMBER:
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TELEPHONE NUMBER:
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BUSINESS NAME AND ADDRESS (Number and Street)
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(City)
(State) (lip Code)
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EMAIL: (Optional)
FAX NUMBER: (Optional)
Fill out this section if principal is a Corporation, Partnership or Trust [Section 2-482 (e)l
. 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:
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II. SPECIFIC LOBBY ISSUE:
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Issue to be lobbied (Descnbe In detail)
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cnv AGENCIES/INDIVIDUALS TO BE LOBBIED:
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A) Full Name of Individual/Title B) Any Financial, Familial or Professional Relationship
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IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WHETHER HOURL Y,
FlATRATEOROTHER): l.
A) LOBBYIST DISCLOSURE: (Required) 0 ) t (7\.. ~"'l;: oS. v-.L. 1
B) PRINCIPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION): (Required), ... l) ~
The following information must be answered:
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1) Pursuant to Miami Beach City Code Section 2-488 Entitled "Prohibited Campaign Contributions By Lobbyists
On Procurement Issues":
DYes n ~ YOU lobbving on a oresent or Dendina bid for Qoods. eauiDment or services. or on a
Dresent or Dendina award for Qoods. eauiDment or service?
2) Pursuant to Miami Beach City Code 2-490 Entitled "Prohibited Campaign Contributions By Lobbyists On Real
Estate Development Issues":
3)
. .
No: Are ou lobb in on a end in a Iication for a 'Develo ment A reement witll the Ci . or
aDDlication for change of zonino maD desiGnation or chanGe to the City's Future land Use
Mao?
Pursuant to Miami Beach City Code 2-484 (hj Any p';rson (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, whetner 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 ~e required to pay any registration fees.. '
. ,
e Are au re resentin a not-for- rofit cor oration or enti without 5 ecial com en ation
or reimbursement.
V. SIGNATURE UNDER OATH:
ON 0Cl'08ER 1 Sf OF EACH YEAR, ~ACH LOBBYIST SHALL SUBMIT TO THE CITY CLERK A SIGNED
STATEMENT UNDER OATH, LISTING LOBBYING EXPENDITURES, AS WELL AS COMPENSATION
RECEIVED, IN TH" ,CITy.oF MIAMI BEACH FOR THE PRECEDING CALENDAR YEAR. A STATEMENT
SHALL BE FILED EVEN IF THERE HAVE BEEN NO EXPENDITURES OR COMPENSATION DURING THE
R.EPORTING PERIOD. ' ~ < ~____
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\, SIgna ure of LobbYIst
I do solemnly swear that all of the foregoing facts are true and correct and that I have read or am
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Signature of Lobbyist: :::.
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VI. LOBBYIST IDENTIFICATION: PRINCIPAL IDEN~FICATION: ,
~ced1Doh"tJe.'l',S J/C(')'Ise ~cedID CI"Y'J'f/e'ros /;'ce~s~
Form of Identification Form of Identification
, .
o Personally known (Lobbyist)
o Personally known (PrinCipal)
VII. SIGNATURE AND STAMP OF NOTARY:
/lE!lIff HalN.IHDEZ'
MY COMMISSION # DO Il26373
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Signature of
Notarizati n of Lobbyist's signature
/ FOR CLERK'S U~NLY
Annual Registralionfee: V]Yes[ ]No Amou~pai~ MCR#~':f-.~
Lobbyist Registration Form received and verified bY:~c::a..
F:\CLER\$ALL\MARlA-M\Lobbyisl\LOBBYIST fORM 0, c
Dale Paid JJ2f:;j6i--
Revised 12/08/04
.
Miscellaneous Cash Receipt
CITY OF MIAMI BEACH
CJ Cash ~it Card
Cl Check #
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28873'
No.
$_\~~
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Received of "".K~ Wennc::::tt-
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FOL~be.M-~-e('\(\e.+- \C\~fi S-T-S ~IS.-\<"a...-h>n.--
(THIS INFORMATION MUST BE COMPLETED)
Account Number:~I-AoCo.3ld"\ . ~
Prwpantr: 0a.\<.c=') Oept:
By
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