2004/2005County of Collier
CLERK OF THE CIRCUIT COURT
COLLIER COUNTY COURTHOUSE
3301 TAMIAMI TRAIL EAST
P.O. BOX 413044
NAPLES, FLORIDA 34101-3044
ORIGINAL
OFFICIAL RECEIPT
When Validated
BY: LINDA HO
DEPUTY CLERK
RECEIPT: 4349918
NAME : MICHAEL MYERS
PAYOR: MICHAEL A. MYERS
REFNC: LAH
DEPT: BOARD MINUTES AND RECORDS
l�1-gt 3 00 0
gjos
V#: 3358953 10/01; i104
CHECK: 25.00
�" W PAID: 25,00
DESCRIPTION AMOUNT
LOBBYIST 25.00
TOTAL DUE: 25.00
Page 01 of 01
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COLLIER COUNTY
3301 Tamiami Trail East
Naples, Florida 34112
BOARD OF COUNTY COMMISSIONERS
LOBBYIST REGISTRATION FORM
DATE
BUSINESS ADDRESS
NAMES AND BUSINESS ADDRESS OF EACH PERSON OR ENTITY REPRESENTED:
1) Uri Kin) j,� F1 wn c
2)
ATTACH ADDITIONAL SHEETS AS MAY BE NECESSARY
b
STATE OF FLORIDA
COUNTY OF COLLIER
The foreon istration wa wo D d subscribed be ore me onthis the ga of
who i erson 1 . to: me or who has
�. FALZARsaa en
Please Notes 1) Failure to renew this registration by the renewal
date of October 1'° will result in the placement of this registrant on
a "status unknowns list. 2) If one wishes to revoke this
registration, a •Lobbyist Withdrawals form must be filed with the
Clerk to the Board. 3) Annual Registration Fee is $25.00 per
Lobbyist according to Ordinance 99-22
Notary ?uClic - Ste^o of Florioa
Nty Ctmmasim F"�Qna Fab 23.2IX)6
Com mission � f)D0795{5
Oonded Ay Natinoal Notary Assn.
by
produced
tificatio and who did take an oath.
BY:
Deputy Cl k/No ary ublic