Lance A. Geller/Prosperous Realty, LLC/Hernan Channah
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,.,.
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 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.
G e. \ \-€. Y LO\. Y\ c.-f...
(Last)
U~./l <.~ A C;<::.\~...
BUSINESS NAME AND ADDRESS
A.
NAME OF LOBBYIST:
(First)
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(State)
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I.
LOBBYIST RETAINED BY:
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BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
':> '"1-S- Y ~- Z. -+
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: \ -\ e .( >"\. <h. ^ C ~(i\""'" - c. ~
. IDENTIFY ALL PERSONS HOLDING, DIRECTLY OR INDIRECTLY, A S% OR MORE OWNERSHIP INTEREST IN SUCH
CORPORATION, PARTNERSHIP OR TRUST: \~ e y' Vl C\ ^ C k a '" I'-- ~ ~
II. SPECIFIC LOBBY ISSUE:
01('"1' /\ c;;.1l.. Or'" t"€..<.'1t' O/" 'So.&<, 'be.: u.-<..IcS If')
Issue to be lobbied (De ribe in detail): "": (., , .A 0 1 \
u.......... ,.--"-.,,,. j r ~ o.~ V
III. CITY AGENCIES/INDIVIDUALS TO BE LOBBIED.
A) Full Name of Individual/TItle
B) Any Financial, Familial or Professional Relationship
3
'N. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COM ENSATION (DISCLOSE WHETHER HOURL Y,
FLAT RATE OR OTHER):
A) LOBBYIST DISCLOSURE: (Required)
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r,
B) PRINCIPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION): (Required),
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":
D Yes ~o: Are yOU 10bbvinQ on a present or pendinQ bid for Qoods. eauipment or services. or on a
present or pendina award for aoods. eauipment or service?
2)
Pursuant to Miami Beach City Code 2-490 Entitled "Prohibited Campaign Contributions By Lobbyists On Real
Estate Development Issues":
~: Are yOU 10bbvinQ on a pendina application for a Development AQreement with the City or
application for chanae of zonina map desiQnation or chanae to the City's Future Land Use
Map?
DYes
3)
Pursuant to Miami Beach City Code 2-484 (h) Any person (except those exempt from the definition of
"lobbyistU 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 1ST 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 EXPEN ITURES ORCQMPENSATION 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 contai d in Section 2-482 of the Miami Beach City Code and all reporting
requirements. )
LOBBYIST ID:Z:;TION:
~ucedID ; ~e
Form of Identification
PRINCIPAL IDENTIFICATION:
Signature of Principal/Client:
VI.
J Produced ID
J Personally known (Lobbyist)
Form of Identification
::.~naIlY known (Principal)
VII.
SIGNATURE AND STAMP OF NOTARY:
",~1A~'f~t:.. .,..
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f*:" :~ MY COMMISSION # DD 181674
State of Florida/ County . ,.~~ade EXPIRES: May 31,2007
Sworn and subscribed b 9" Bonded Thru NolarypubilcUnderwnlers
Th;S~Yof~~1. "-- '
Sign~ Of~-;-ry - State of Florida
Notarization of Principal/s signature
LANCE GELlER
Annual Registration fee: [ Yes [ ] No
Lobbyist Registration Form received and verified "
F:\CLER\$ALL\MARIA-M\Lobbyist\LOBBYIST fOR~' S. c