2013/2014 c.
I rk to the Board, Minutes& Records Dept. Expires 120 l
C e o p p I
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3299 Tamiami Trail East, Suite#401 (Staff use only)
Building F, 4th Floor
Naples, FL 34112
BOARD OF COUNTY COMMISSIONERS
LOBBYIST REGISTRATION FORM
Name David Farmer Date
Business Address 240 17th ST SW
Naples, FL 34117
Business Telephone 239-292-6081 E-Mail dave@keystonellc.net
NAME AND ADDRESS OF EACH PERSON OR ENTITY REPRESENTED:
1) Kraft Office Center, LLC 3530 Kraft Road, Suite 204, Naples
2) Cl Bank 100 5th Street South St. Petersburg, FL 33701
First National Bank of the Gulf Coast 3560 Kraft Rd, Naples
(PLEASE ATTACH ADDITIONAL SHEETS,IF NECESSARY)
41)/ (1
Lobbyist Signature
State of Florida
County of Collier
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The foregoing registration was sworn to and subscribed before me on this
day of 8...),"-L.i2Ol ci, by `— ,who is personally known to
me or has produced as identification and
who did take an oath.
BY: ®
Deputy Cler rotary 'ublic
The annual registration fee is$25.00 per Lobbyist,acvQrding to Collie ,unty
Ordinance No. 2003-53, as amended by Ordinance 2004 05,-Ordinance 2007-24
and Ordinance 2013-39.
Please make payment to: Collier County Clerk of Courts Or
Dwight E. Brock, Clerk of Courts and mail to the address listed at the top of the form.
Receipt# 007461966
6/23/2014 1:07:21 PM
' Dwight E. Brock
Clerk of the Circuit Court
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Customer Deputy Clerk Clerk Office Location
DAVID FARMER BMR CASHIER Collier County Govt. Center
DAVID FARMER MinutesandRecords @CollierClerk.co Building F, 4th Floor
240 17TH ST SW m 3299 Tamiami Trail East, Suite
NAPLES, FL 34117-3310 239-252-2646 401
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# 1433 ($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.
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