Richard Freeman/Villazzo, LLCm 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 princpal who seeks to encourage the passage, defeat
or modification of any ordinance, resolution, action or derision of any wmmissioner; any action, derision, 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 rewmmendation that foreseeably will be heard or reviewed
by the city commission, or a city board or committee. The term sperifically includes the principal as well as any employee engaged
in lobbying activities. The term "Lobbyists" has specific exclusions. Please refer to Ordinance 2004-3435.
NAME OF LOBBYIST: (Last) (First) ~ (M.I)
Rirc-f~R1~ ~R~~MA~~~Ssoc~r~r_~:r~;!/Q ~)AS~{~n~~'a~ $V~: ~Srr~_ ~-~ r - ~rl /-c- _~~i3~
BUSINESS NAME AND ADDRESS (Nu er and Street) (City) Sta e) (Zip Code)
TELEP ONE NUMBER: FAX NUMBER: E ~ AIL:
I. LOBBYIST RETAINED BY:
VILL~12-Z~, C.LC
NAME OF PRINCIPAUCLIENT`.
BUSINESS NAME AND ADDRESS (Number and Street- (City) (State) (Zp Code)
TELEPHONE N MBER: 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:
~~Ri ~(~~ ~>~G~~~~>~sKr
• IDENTIFY ALL PERSONS HOLDING, DIRECTLY OR INDIRECTLY, A 5% OR MORE OWNERSHIP INTEREST IN SUCH
CORPORATION, PARTNERSHIP OR TRUST:
.S~Mc
II. SPECIFIC LOBBY ISSUE:
S~ ~ c ` L S G ' -~ - ~~ c
Issue to be lobbied (Describe in detail):
III. CITY AGENCIES/INDMDUALS TO BE LOBBIED:
A) Full Name of Individual/Title B) Any Financial, Familial or Professional Relationship
~ C ~ ,Y ~ ~ t1 ti ' ~~ '~
Ali' ~i .-r ., ~t~ /'
; \ /
IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WHETHER HOURLY,
FLAT RATE OR OTHERt
A) LOBBYIST DISCLOSURE: (Required) ~/~ ~ 1~6 ~a too -L QJ
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":
o/ uresent or oendina award for goods, eauioment or service?
2) Pursuant to Miami Beach City Code 2-490 Entitled "Prohibited Campaign Contributions By Lobbyists On Real
Estate Development Issues":
aoolication for chance of zoning mao designation or chance to the Citv'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 anot-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..
or reimbursement. .
V. SIGNATURE UNDER OATH:
ON OCTOBER 1~ 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~HE PRECEDING CALENDAR YEAR. A STATEMENT
SHALL BE FILED EVEN IF THERE HAVE BEEN ~tOj EXPENDITURES OR COMPENSATION DURING THE
REPORTING PERIOD. j ' / /
-.
Signature Lobbyist
I do solemnly swear that a f the foregoing facts are true and correct and that I have read or am
familiar with the provision ntained in Section 2 of the Miami Beach City Code and all reporting
requirements. '~-~ . ~~ f, ~€~,,.;c.
Signature of Lobbyist:
Signature of Principal/Client:
VI. LOBBYIST IDENTIFICATION: PRINCIPAL IDENTIFICATION:
^ Produced ID ^ Produced ID
Form of Identification Form of Identification
Personally known (Lobbyist) ~"'~ "`""' " -" GLP'ersonally known (Principal)
VII. SIGNATURE AND STAMP OF NOTARY:
State of Florida, County of Miami-Dade
Sworn to and subscribed before me
This day of , 20_
State of Florida,
Sworn and subs
This days
~~
Signature of Pyle
Notarization o
o--N D. ZARIF
STATE OF FLORIDA
N A~DD294059
~~R ~e. 2s, 2ooa
2~
Signature of Public Notary -State of Florida
Notarization of Lobbyist's signature
FOR CLERK'S USE ONLY
Annual Registration fee: [~] Yes [ ] No Amount P id MCR # a,-'1~~'~-~~ [Date Paid o
Lobbyist Registration Form received and verified by: _
F:\CLER\$ALL\MARIA-M\Lobbyist\LOBBYIST fORM 05.doc Revised 12/08/04
rtty-l~-~ee~i 14:1rJ I-r9lTt:'J1LLH~`U 1.~~~rrrr~l~+r io:~e~ hr~r~~y r.~r~
IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WHETHER NQURLY,
FLATRAT><OR OTHERr
A) LOBBYIST DISCLOSiJRC: (Requlrsd) ~-~~ r~ - ~
8) PRINCIPAL'S DISCLOSURE (OF L08BYI5T COMPENSATION): (Requlrod). , •~~ ~~~ ..
The following information must be answered:
1) Pursuant [a Mlaml Beach City Code Section 2-488 Entitled "Prohibited Campaign Contrlbutlons By Lobbylstr
On Procurement Issues":
2) Pursuant to Miami Beach Clty Code 2-990 Entitled "Prohibited Campaign Contrlbutlons By Lobbyists Qn Real
Estate Development Issues":
~jl~l~n for ch~sn4g of zonlna man designation or chance to the Citv'a FuturQ Lpnd Uee
1Mau?
3)
Pursuant to Mlaml Beach Clty Code 2-484 (h) Any person (except those exempt from the definition of
"lobbyist" as set forth In Section Z-481 above) who only appears as a representative of a not-for-profit
corporation or entlry without special Compensdtlon or reimbursement for the appearance, whether direct, or
Indirect, to express support of or opposition t4 any item, shall register with the clerk a5 reQUlred by this
section but, shall not be required to pay any registration fees..
ON OCTOBER 1~ OF EACH YEAR, EACFiI 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
5HALL BE FILED EVEN IF THERE HAVE BEEN NO' EXPENDITURES OR~(~MPENSATION DURING THE
REPORTING PERIOD. / -
f '1 '' '
• Signature f Lobbyist
I do solemnly swear that ati'Df the foregoing facts are true and correct and that I have read or am
familiar with the provlsion~'r ~ nt'alned In Sect(on~-4$2 of the Miami Beach City Code and all reporting
requirements. 1 y . r' ",
Signature of Lobbyist: ~ ~.V+~ ~ ~ ti ~ ~~"~ _
Signature of Principal/Client:
VI. LOBBYIST IDENTIFICATION:
Produced 1D
[~ Produced ID
Form of Identification
- '° ' °~ C.Personally known (Principal)
VII. SIGNATURE AN[) STAMP OF NOTARY:
of Dublic Notary -State of Florida
lion of Lobbyist's signature
State of Florida,
Sworn and Subsci
This day
ItN O. TARIF
STATr` OF FLORIDA
N ~ DD2:84059
tPIR FEB. 25, 2008 r
,-- 2.w 6
Signature of Pybi1
Notarization of
FOR CLERK'S USe ONLY
Annual R@tjlStTdtion ree: ( ]Yes [ ] No Amount Paitl MCR # Oate Paid
Lobbylat Repls7anon form recewea and verified by:
F;\CLER\SA1.L\MAAlA•M\Lobbyist\LOBB`(IST FORM 05.doC Revised 12/08/04
r / J ., `
PRINC2PAL IDENTIFICATION;
Form of Idenditcatlon
Personally known (LObbylStJ '"
V. SIGNATURE UNDER OATH: