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2019/2020 Collier County Clerk of Courts Expires U 202/u 3299 Tamiami Trail E. (Clerk's of ce only) Suite 401, Bldg. F, 41" Floor Naples, Florida 34112 BOARD OF COUNTY COMMISSIONERS LOBBYIST REGISTRATION FORM Name J AMES B11'n' i Date I " ) �" Z.019 Business Name J 11448 1(ZJ3 N s p0 R T 4- T V pi E`'6 Business Address 41 1 1 L //we- s City N!-c PL6--$ State F 1--- Zip Code 3.1 I 1 l Business Telephone 23 1 " '111- 2167 Contact Person \..)11171 641✓)<� Lobbyist E-mail J M i S ( /"6 e @M SP , Co ni 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 Crystal K. Kinzel, Clerk of Courts (ADDRESS LISTED ABOVE) NAME AND ADDRESS OF EACH CLIENT/ENTITY REPRESENTED: 1. Name 2. Name Address Address City Zip Code City Zip Code 3. Name 4. Name Address Address City Zip Code City Zip Code (ATTACH ADDITIONAL CLIENT SHEETS,IF NECESSARY) State of Florida Atil"County of Collier Lob.yist , , ature , This r gistration was worn (or affirmed) and subscribed b-1 •re me this— day ot, . , 20 /(I, by c_ji VY (ta.Y\ fib PPersonally Known BY. ;_ " '1�._- Si! �`a � Produced ID Deputy erk/Nota ublic NO Type of ID Produced Re --:.08/2018 Receipt# 008119638 9/19/2019 12:27:21 PM coy�,ER�o�tir� Crystal K. Kinzel Clerk of the Circuit Court and Comptroller co THE CIR0J Customer Deputy Clerk Clerk Office Location JAMES BANKS BMR CASHIER Collier County Govt. Center JMB TRANSPORTATION ENG MinutesandRecords@CollierClerk.co Building F, 4th Floor 761 21ST ST NW m 3299 Tamiami Trail East, Suite NAPLES, FL 34120-1813 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 Cash Tendered ($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. ©0AR0GT©ill® g0lE0 Page 1 of 1 Lobbyist Registration Quarterly Update '•••,,,, / Collier County Clerk of Courts Expires 3299 Tamiami Trail E. (Cleric's office only) Suite 401, Bldg. F, 4th Floor Naples, Florida 34112 BOARD OF COUNTY COMMISSIONERS \ LOBBYIST REGISTRATION FORM J Name AM e S (SAN'io Date 1" 14 ' lo Z 0 Business Name iM Q `QApi.sto geritsi o" 6 NG. TPJ C - Business Address 41 1 ) / tl- Av6 Sul NAP" $ F - 310 City State Zip Code (,� Business Telephone I' qi 1' 2161 Contact Person Lobbyist E-mail 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, Ordinance 2007-24 and Ordinance 2013-39. Please make payment(s) to: Collier Clerk of Court. (Mail to the address listed at the top of the form) NAME AND ADDRESS OF EACH CLIENT/ENTITY RE RESENTED: 1. Name ij'd W V, 2. Name,---\< . Address Address City/State Zi% ity/State Zip 3. Name 4. Name Address Address 1 City/State 6ip City/State Zip (ATTACH ADDITIONAL CLIENT SHEETS,IF NECESSARY) State of Florida Ilk County of Collier Lo•by • Si: ature This registration was sworn (or affirmed) and subscribe. •efore me this day of, , 20 , by Personally Known BY: Produced ID Deputy Clerk/Notary Public Type of ID Produced Revised:08/2019