Donald Washburn/304-312 Ocean Drive, LLCm MIAMBEACH
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 tb encourage the passage, defeat
or modification of any ordinance, resolution, action or deasion of any commissioner; any action, decision, recommendation of the
City Manager or any dty 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, deasion or recommendation that foreseeably will be heard or reviewed
by the aty 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 spedfic exclusions. Please refer to Ordinance 2004-3435.
Washburn Donald J.
NAME OF LOBBYIST: (Last) (Rrst) (M.I)
The Audio Bug, Incorporated 3800 Hillcrest Drive, Unit 102 Hollywood FL 33021-7937
BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
954-983-2788 954-983-2789 audiobug 1 @aol .corn
TELEPHONE NUMBER: FAX NUMBER: EMAIL:
I. LOBBYIST RETAINED BY:
304-312 Ocean Drive, LLC
NAME OF PRINCIPAL/CLIENT:
600 North 3rd Street, 2nd Floor Philadelphia PA 19123
BUSINESS NAME AND ADDRESS (Number and Street) (Gty) (State) (ZJp Code)
(215) 625.9722 (215) 625-0167 louisjorocofsky@earthlink.net
TELEPHONE NUMBER: FAX NUMBER: (Optional) EMAIL: (Optional)
FII out this section tf prindpal is a Corporation, Partnership or Trust [Section 2-482 (c)]
• NAME OF CHIEF OFFICER, PARTNER, OR BENEFICIARY: Phillip McFllin, Louis Orocofsky
• IDENTIFY ALL PERSONS HOLDING, DIRECTLY OR INDIRECTLY, A 5°k, OR MORE OWNERSHIP INTEREST IN SUCH
CORPORATION, PARTNERSHIP OR TRUST: Phillip McFillin
II. SPECIFIC LOBBY ISSUE:
Redevelopment of 302-312 Ocean Drive - COA, Variance Approvals and Conditional Use Permit
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 Professiorml Relationship
Planning Dept. HPB, NOS, Planning Board, City Commission' None
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* Unless an issue is legislative in nature, HPB, BOA, Planning Board, and pty Commission members anq r~ ta~bigd`~ ~u~d~-~ a public hearing setting.
i~ Personally known (Lobbyist)
NOTARY PUBLIC-STATE OF FLORIDA
^ Personally known (Principal)
STAMP OF NOTARY:
Bonded t~~~o~t ti~T01'e ~
This 6th day of 'August . 20Q$
State of Fkxida, County of Miami-Dade
Sworn and subscribed before me
This day of . 20
Sign~tUre of Public Notary -State
Notarization of Lobbyist's sig>A
Signature of Public Notary -State of Florida
Notarization of Principal's signature
d ~ ~k t FOR C'LERK'S USE ONLY G~ ~/,
Annual Registration fee: [ ]Yes [ ' ] No Amount Paid ~~ MCR # ~ ( ~" i7~ to Paid ~ t/ O
Lobbyist Registration Form received and verified by: Entered By: _~ ~ ,
F:\OLER\~ALL\MARIA-P~1Lobbyist\LOBBYfST FORM OSAoc RevLSed 12/06/04
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rare •w. ~; v -
City of Miami Beach, 1700 Convention Center Drive, Miomi Beach, Florida 33139, www.miamibeochfl.gov
CITY CLERK Office
Tel: 305.673.741 1 ,Fax: 305.673.7254
C ir~Clerk~miamibeochfl.gov
LOBBYIST NAME:
Donald J. Washburn
I understand that no later than October 1st of each ear, I must file the following
forms, pursuant to Section 2-485 of the Miami Beach City Code, with the City Clerk's
Office For all active lobbying issues.
1 j Lobbyist Expenditure Form
2j Disclosure Form
Failure to file these forms on a timely basis will result in my name being transmitted to the
Miami-Dade County Commission on Ethics and for code violation evaluation.
In addition, once an issue 1 have registered to lobby on has been resolved, I am required
to immediately notify the City Clerk's Office of lobbyist withdrawal in writing.
August 6, 2008
Signature: Date:
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