2013/2014 Collier County Clerk of Courts Expires —111 2.01L-1--
3299 Tamiami Trail E. (Clerk's office only)
Suite 401,Bldg. F, 4th Floor
Naples, Florida 34112
BOARD OF COUNTY COMMISSIONERS
LOBBYIST REGISTRATION FORM
Name F. J a N-e_g ti.AQ Cel l U Date S' ) i g )0(_ ) 3
Business Name_ tAC � �Q� jn,(-Q)d_ i v ?wJ9
Business Address 5(o TP taua^re sc ) C OY SSITm
City 41-0 State N' Zip Code Lia.0 a---
Business Telephone 116 "-DOI t Contact Person -Q ([3 MO.0
Lobbyist E-mail J f m n G,MCiyil rc_9(7) , (�(3 v
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 f J ck..meg ICI C CD IAI.re_, 2.Name
Address 6 too e I a 59t't° Address
Cityg-{ . LkX
sio,-Ay Zip Code)0 City Zip Code
3. Name 4. Name
Address Address
City Zip Code City Zip Code
(ATTACH ADDITIONAL CLIENT SHEETS,IF NECESSARY)
State of Florida KV r.�4---
County of C.-oilier el...A.JL u -�
Lobbyist Signature
This registration was sworn (or affirmed) and subscribed before me this 19 day of,
AULI , 20 13 , by F. J a,mes M c Ci ui n
t/ Personally Known BY: 1' / �pu�av�cl�wi
Produced ID r eputy Clerk/Notary Public
Type of ID Produced
PHYLLIS E.LEWANDOWSKI
Notary Public,State of New York
Qualified in Erie Co.,No.30,5 Revised: 08/2011
Commission Expires Aprii
Receipt# 007383600
10/4/2013 2:36:48 PM
Dwight E. Brock
c ` :tile
Clerk of the Circuit Court
•
( 101)Eir C-7 C ip
Customer Deputy Clerk Clerk Office Location
F. JAMES MCGUIRE BMR CASHIER Collier County Govt. Center
MCGUIRE DEVELOPMENT- MinutesandRecords @CollierClerk.co Building F, 4th Floor
AIRPORT PULLING ORANGE m 3299 Tamiami Trail East, Suite
BLOSSOM 239-252-2646 401
6050 DELAWARE AVE STE P.O. Box 413044
400 Naples, Florida 34101-3044
BUFFALO, NY 14202-2014
1 Product
QUANTITY DESCRIPTION UNIT COST AMOUNT
1 BMR Lobbyist Registration $25.00 $25.00
TOTAL AMOUNT DUE $25.00
Check# 165 ($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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