2012/2013Collier County Clerk of Courts
3299 Tamiami Trail E.
Suite 401, Bldg. F, 4th Floor
Naples, Florida 34112
Expires L f
(Clerk's office only)
BOARD OF COUNTY COMMISSIONERS
LOBBYIST REGISTRATION FORM
Name Douglas L. Rankin Date 9/28/12
Business Name Law Office of Douglas L Rankin
Business Address 2335 Tamiami Trail North., Suite 308
City Naples State FL Zip Code 3 410,9
Business Telephone 239-262-0061 Contact Person Douglas L. Rankin
Lobbyist E -mail dranki ngGnri ntma i 1 com
Notice for Lobbyists: The annual registration fee is S25.00 per Lo ist, 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:
Address
City
3. Name
Address
Zip Code
City
4. Name _
Address
City Zip Code City
(ATTACH ADDITIONAL CLIENT SHEETS, IF NECESSARY)
Zip Code
Zip Code
State of Florida
County of Collier
Lobbyist Signature���
This registration was sworn (or affirmed) and subscribed before me this
20L'Z:::�, by y v�
'71— Personally Known BY:
Produced ID Deputy er t Public
Type of ID Produced
Revised: 08/2011
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Dwight E. Brock
Clerk of the Circuit Court
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10/1/2012 10:04:16 AM
Customer Deputy Clerk
Clerk Office Location
DOUGLAS L. RANKIN BMR CASHIER
Collier County Govt. Center
LAW OFFICE OF DOUGLAS L. MinutesandRecords @CollierClerk.co
Building F, 4th Floor
RANKIN m
2335 TAMIAMI TRL N STE 308 239 - 252 -2646
3299 Tamiami Trail East, Suite
401
NAPLES, FL 34103 -4458
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# 10834 ($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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