Allan Shulman/Thor ACQ, 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 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.
Shulman Allan T~
NAME OF LOBBYIST: (Last) (First) (M.I)
Allan T. Shulman Architect, P.A. 100 NE 36 Street Miami, Florida 33137
BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
(305) 438-0609 (305) 438-0170 allan@shulmanarchitect.com
TELEPHONE NUMBER: FAX NUMBER: EMAIL:
I. LOBBYIST RETAINED BY:
Thor ACQ, LLC
NAME OF PRINCIPAL/CLIENT:
25 West 39`h Street New York NY 10018
BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
(212) 529-7415
TELEPHONE NUMBER: 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: Joseph J. Sitt
IDENTIFY ALL PERSONS HOLDING, DIRECTLY OR INDIRECTLY, A 5% OR MORE OWNERSHIP INTEREST IN SUCH
CORPORATION, PARTNERSHIP OR TRUST: Joseph J. Sitt
II. SPECIFIC LOBBY ISSUE:
Redevelopment of 910 Lincoln Road
Issue to be lobbied (Describe in detail):
III. CITY AGENCIES/INDIVIDUALS TO BE LOBBIED:
A) Full Name of Individual/Title B) Any Financial, Familial or Professional Relationship
ing Dept., HPB, BOA, Planning Board, City Commission ~ None
lV. U1,GLVDUKt Vt ItKM~A1YU AMVUIYIJ VF LUtitfTl~l I:UMYCIY,Al1U1Y (U1Dl.LUDt WI'7tIFItK /'/UUKL1,
FLAT R;4TE OR OTHERf //'~ ,,
A) LOBBYIST DISCLOSURE: (Required) ~J~~ V ~ ~ ~-'~ ~
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":
^ Yes X No• Are you lobbvina on a present or ~endina bid for aoods eyuinment or services or on a
present or gendina award for goods eauinment or service?
2) Pursuant to Miami Beach City Code 2-490 Entitled "Prohibited Campaign Contributions By Lobbyists On Real
Estate Development Issues":
^Yes X No• Are you lobbying on a pending application for a Development Agreement with the Citv or
~~lication for chanae of zoning map designation or chanae to the City's Future Land Use
Maa?
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..
^ Yes X No• Are you representing anot-for-profit corporation or entity without special comaensation
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 THE PRECEDING CALENDAR YEAR. A STATEMENT
SHALL BE FILED EVEN IF THERE HAVE BEEN NO EXPENDITURES OR COMPENSATION DURING THE
REPORTING PERIOD.
Signature of Lobbyist
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 contained in Section 2-482 of the Miami Beach City Code and all reporting
;requirements. ~-
Signature of Lobbyist: ~~~~~~ ~ ~~ ~?~~ ~ ~~---,
Signature of Principal/Client:
d N oVI. LOBBYIST IDENTIFICATION:
~ ~ M O ~:
~ U u, N ~ ^ Produced ID
~ Q N Form of Identification
`',.~ o `~" personally known (Lobbyist)
-~ ed .~
`''~" f~ VII. SIGNATURE AND STAMP OF NOTARY:
La_7
0
State of Florida, County of Miami-Dade
~' Sworn to and subscrib before me
~~ ' ~ This ~,~day of ~ ~ 20 ~
~ ~ .~.
~~ -~ .
Signature of Publi Notary -State of Florida
Notarization of Lobbyist's signature
PRINCIPAL IDENTIFICATION:
^ Produced ID
Form of Identification
^ Personally known (Principal)
State of Florida, County of Miami-Dade
Sworn and subscribed before me
This day of , 20_
Signature of Public Notary -State of Florida
Notarization of Principal's signature
FOR CLERK'S USE ONLY r
Annual Registration fee: [ ] Ye~--~No Amount Paid ~5~ ~'~ MCR # Date Paid e~ ~
/' i
Lobbyist Registration Form received and verified by~( ~~Entered By: _ - Zrzv~, ;~~~
F:\CLER\$ALL\MARIA-M\Lobbyist\LOBBYIST fORM OS.doc Revised
~4 /i ~c/~
IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WHETHER HOURLY,
FLAT RATE OR OTHERJ:
A) LOBBYIST DISCLOSURE: (Required) ~
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":
^ Yes X No Are you lobbving on a aresent or pending bid for aoods eauipment or services or on a
present or pendina award for aoods equipment or service?
2) Pursuant to Miami Beach City Code 2-490 Entitled "Prohibited Campaign Contributions By Lobbyists On Real
Estate Development Issues":
^Yes X No Are you lobbving on a pendina application for a Development Agreement with the City or
application for change of zoning_map designation or change to the City's Future Land Use
Map?
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 snot-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..
^ Yes X No Are you reeresentina snot-for-arofit corporation or entity without saecial comaensation
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 THE PRECEDING CALENDAR YEAR. A STATEMENT
SHALL BE FILED EVEN IF THERE HAVE BEEN NO EXPENDITURES OR COMPENSATION DURING THE
REPORTING PERIOD.
Signature of Lobbyist
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 contained in Se ion 2-482 oft Miami Beach City Code and all reporting
requirements.
Signature of Lobbyist:
Signature of Principal/Client:
VI. LOBBYIST IDENTIFICATION:
Produced ID
Form of Identification
Personally known (Lobbyist)
VII. SIGNATURE AND STAMP OF NOTARY:
State of Florida, County of Miami-Dade
Sworn to and subscribed before me
This day of , 20_
Signature of Public Notary -State of Florida
Notarization of Lobbyist's signature
PRINCIPAL IDENTIFICATION:
Produced ID
Form of Identification
Aa•`G~,4 FERnq ,,
r ~ ~ NEW y~.,~~~N
~~_~
`-~ersonally known (Principal)
State o oun of e ~ .•
Sworn and subscribed before me ~'y~,,y N~µESM~•'•~
This 1~day of , 20~g ~
~~
Signature of lic Notary -State of F~4er~anlev+~lo~
Notarization of Principal's signature
/'~ FOR CLERK' USE QNLY !~ ~/
Annual Registration fee: [ ] Yes~JVo Amount Pai ~. ~ MCR # o` ~~Date Paid ~ ~5
lobbyist Registration Form receivedl'and~verified by: ~ Ente}~ed By:
F:\CLER\$ALL\MARIA-M\Lobbyist\LOBBYIST fORM OS.doc Revised 12/08/04