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2013/2014 Collier County Clerk of Courts Expires 26/ 3299 Tamiami Trail E. Suite 401, Bldg. F,4t"Floor (Clerk's office only) Naples, Florida 34112 BOARD OF COUNTY COMMISSIONERS LOBBYIST REGISTRATION FORM Name Michael R. N. McDonnell Date 08/09/2013 Business Name McDonnell Trial Law Business Address 5150 Tamiami Trail North, Suite 203 City Naples State Florida Zip Code 34103 Business Telephone (239) 434-7711 Contact Person Michael McDonnell Lobbyist E-mail Mike(a�mctrial.com 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 Dominick Cammuso 2. Name Address 9168 The Lane Address City Naples Zip Code 34109 City Zip Code 3. Name 4. Name Address Address City Zip Code City Zip Code (ATTACH ADDITIONAL CLIENT SHEETS,IF NECESSARY) State of Florida •P County of Collier L •byist Signature CI-4A This registration was sworn(or affirmed) and subscribed before me this day of, This 2013,by MICHAEL R.N. McDONNELL. T toNES STATE OF ri w OFdDA .. X Personally Known BY: .11 , c. ry ,., -- L/ti Produced ID Deput 4 k/Notary Public Type of ID Produced Revised:08/2011 Receipt# 007369412 8/20/2013 8:22:36 AM ,�-.-ii,, Dwight E. Brock 0:-.-____-._Ar*. ~, ;. Clerk of the Circuit Court :,fir „°1 __ o — o ,F,__ _�...- 0 gi_ , _ ��� D ER ftk t:7RC' Customer Deputy Clerk Clerk Office Location MICHAEL R. N. MCDONNELL BMR CASHIER Collier County Govt. Center MCDONNELL TRIAL LAW MinutesandRecords @CollierClerk.co Building F, 4th Floor 5150 TAMIAMI TRL N STE 203 m 3299 Tamiami Trail East, Suite NAPLES, FL 34103-2818 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# 1288 ($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. gc11[111®G'gIbTflag0olia Page 1 of 1