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2013/2014 Collier County Clerk of Courts Expires 2014' 3299 Tamiami Trail E. (Clerk's office only) Suite 401,Bldg. F, 4th Floor Naples, Florida 34112 BOARD OF COUNTY COMMISSIONERS LOBBYIST REGISTRATION FORM --r---61-q-' 2 2-2097 Name "06!y/.75 i.,Zj-il i7_= Date V/2// Business Name LAW OFFICE OF Business Address DOUGLAS L RANKIt4 1OOKINu PROFESSIONAL BUILO 35 TAMIAMI TRJ,ti,.NORTH SUI'1E308 City NAPI FS,FL .i Zip Code Business Telephone 2 3'7 2 672_O66/Contact Person ®"Z45 �z,4f/�� lam' Lobbyist E-mail i► ,e. -z mil / ` /477{l</e G.Gs' Notice for Lobbyists: The annual registration fee is $25.00 per Lobbyist, per Collier County Ordinance No. 2003-53, and amended by Ordinance 2004-05 and Ordinance 2007-24. Payments made out to: Collier County Clerk of Courts or Dwight E. Brock, Clerk of Courts (ADDRESS LISTED ABOVE) NAME AND ADDRESS OF EACH CLIENT/ENTITY REPRESENTED: 1. Name 5'c9r 9L ` ' _ ! 7' — 2. Name , C ,T 060 yV yL FL:--,L Address 0-1-1 J . P42.:_. Address / g3 S,) LyS C41 City 1-4-"" ir ((e Lip Co City / , �1', Zip Code 4/f/f 3. Name _ = �d 6 0 i z Name g6---6 L� Address /53 5u Address l K O S�� 01,1 /-*,, y City Zip Code ' `l City Wi / Zip Code 3 11 V(ATTACH ADDI ONAL CLIENT SHEETS,IF NECES ARY) State of Florida County of Collier Lobbyist Signature his registration was sworn (or affirmed) and subscribed before me this / , day of, A1J&• , 20/ 3 , by . 06445 A, ti�(0 . , . �. n ! Personally Known B �!', ,_,��i.`4.,_2_,4 _.../ Produced ID Desu riZEft. , Public Type of ID Produced ' 7 CAROL A.LEUSCHNER a' ; s.;: 'a ,. MY COMMISSION S DD 992074 t.,-,,,;.y EXPIRES:June 15,2014 Revised:08/2011 'J?„o•" ' Bonded Thru Notary Public Underwriters Receipt# 007367434 8/13/2013 1:40:40 PM c>t`arKC:4?r�T� Dwight E. Brock Clerk of the Circuit Court '„:2k�,\ i Lc/2V o 10A`1/ I/' Customer Deputy Clerk Clerk Office Location DOUGLAS RANKIN BMR CASHIER Collier County Govt. Center LAW OFFICE OF DOUGLAS L. MinutesandRecords @CollierClerk.co Building F, 4th Floor RANKIN m 3299 Tamiami Trail East, Suite 3225 TAMIAMI TRL N STE 308 239-252-2646 401 NAPLES, FL 34103-4106 P.O. Box 413044 Naples, Florida 34101-3044 1 Product QUANTITY DESCRIPTION UNIT COST AMOUNT 1 BMR Lobbyist Registration $25.00 $25.00 TOTAL AMOUNT DUE $25.00 Check# 11590 ($25.00) BALANCE DUE $0.00 Note: Disclaimer: All transactions are subject to review/verification. The Clerk reserves the right to correct for clerical errors and to assess or refund charges as needed. ©CDUOCST1©1 C;G'i3❑@C f Page 1 of 1