HomeMy WebLinkAboutSchnidman Lobbyist Form• •- - •'o.¢=ouaMAIL rcc nueCUVe 1nrough 12/3U2018
Print Form
,pit SEP PH 12: 00
'f" CLERIC
of MIAMI LOBBYIST REGISTRATION FORM
(1) Lobbyist Name: S C11{ti;. 00 yq dr 1 Filet t'I k
(Last Name, First Name, Middle Initial)
ur`
For Office
Use Only:
Check# / / D
Receipt# C p 5-V 7
Business Phone:
Business Address:
Email Address:
CITY OF MIAMI
ri Check box
Li if Principal
&. x ��.1337 Fort-- Q e cQclr f e azip 3 7?
Sclni vitaHT e 4LL KK .. w
(2) Principal Represented: rn C�• t2. C 61
Business Address: / 1 �? c� C'.�1 �c' L ! C'. .. r�- i i �' i'1 i.+�. � (c i`c L 6 t. i 1dip � ,^ 3 f 3 L /
-
(3) Specific issue associated with lobbying (if representing a corporation, partnership or trust give business address of
chief officer, partner, or beneficiary of same, and the names and addresses of all persons holding, directly or
indirectly, at Least five percent (5%) ownership interest in said corporation, partnership or trust).
(4) Lobbyists shall state the extent of any business association, partnership, or financial relationship with the Mayor,
any member of the City Commission, any member of a City board, the City Manager or a member of the City staff
before whom he or she lobbies, or intends to lobby.
Q.
Lobbyists shall pay all registration fees ($525.00 annually, plus $105.00 for each principal represented and for each issue
a lobbyist has been retained to lobby on behalf of any one principal), and specifically define the issue for which they are
employed. The Clerk shall reject any statement which does not detail the issue for which the lobbyist has been employed.
Each lobbyist shall, within sixty (60) days alter registering as a lobbyist, submit to the City Clerk's Office a
certificate of completion of an ethics course offered by the Miami -Dade County Commission on Ethics & Public
trust ("Ethics Commission"). Lobbyists who have completed the initial ethics course mandated by the preceding
sentence and have continuously registered as a lobbyist thereafter shall be required to complete a refresher ethics
course offered by the Ethics Commission every two (2) years. Each lobbyist who has completed a refresher ethics
course shall submit a certificate of completion within sixty (60) days after registering as a lobbyist.
I do solemnly swear that all of the foregoing facts are true and correct, and I have read or am familiar with the provisions
contained in Secmnsti251 through 2-658 of the Miami City Code, as amended.
.4
el
NOTARY PUBLIC
STATE OF FLORIDA
Comm# FF206788
Expires 6/24/2019
'tate of Florida, County of Miami -Dade
'sworn to and subscribed before me this
2`'day of 014 i✓k5/— .
/I 1.4 (-4 C? Lt Ler 2( �
Lobbyist Signature
`zi �, 9L .-eA..t;.r
`
Notary or-Dputy Clerk
Office of the City Clerk, 3500 Pan American Drive, Miami, FL 33133 / Phone: (305) 250-5361 / Email: clerks@miamigov.com
No. 486547
. _ /
$ Sales Tax $ Total $ �-' Date•9 ['
rr sr
_.l r ! r. --t c,�� ....„ /100 Dollars
1
Received from*
Address r �� .Ivy / CUI
For:
This Receipt not VALID unlessdated,
filled in and signed by authorized em-
ployee of department or division des-
ignated hereon and until the City has
collected the proceeds of any checks
tendered as payment herein.
FN/TM 402 Rev. 03103
FRANK SCHNIDMAN
PO BOX 11339
FORT LAUDERDALE, FL 333391339
Pay to the orderof
J1n
c obank'
CITIBANK, N.A. j _�r
Memo L i O Ir4,1/ ;St"- (R�o
1:2660h65541: 9 L L483 L 1.730 L L89
By.
City of Miami
OFFICIAL RECEIPT
Reference No.
Department*
/1Ur(
0, C.: l'E r/1"
Division'
Distribution: White - Customer: Canary - Finance: Pink - Issuing Department
63-6655124
2660
Date
1189
2?Zorn