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: 4347859
NAME : TOM TAYLOR
PAYOR: THOMAS M. TAYLOR
REFNC: LAH
DEPT: BOARD MINUTES AND RECORDS
T - v6ock9
Cl/05
V#: 3356978 09/29/2004
CHECK: 75.00
MC AMT PAID: 25.00
DESCRIPTION AMOUNT
LOBBYIST 25.00
TOTAL. DUE: 25.00
Page 01 of 01
Tr 0- 06
COLLIER COUNTY
3301 Tamiami Trail East F.4
Naples, Florida 34112
BOARD OF COUNTY COMMISSIONERS
LOBBYIST REGISTRATION FORM
DATE 9/23/04
�RE!11111!11!sri- ..
BUSINESS ADDRESS Hole Montes
950 Encore Way
Naples, Florida 34110
NAMES AND BUSINESS ADDRESS OF EACH PERSON OR ENTITY REPRESENTED:
1) SEE ATTACHED LIST
2)
ATTACH ADDITIONAL SHEETS AS MAY BE NECESSARY
tA "h - —
Lobbyist Signature
STATE OF FLORIDA
COUNTY OF COLLIER
The foregoing registration was sworn to and subscribed before me on
this the 23rd day of September, 2004 by Thomas M ZaY or
6rx x�tietsx:P�dznomdx
js .rmwew+a identification and who did take an oath.
eM1s+e BY •�
=A�. .) putt' C1er1C/No� Public
please Notec 1) Failure to renew this registration by the renewal
date of October 1it will result in the placement of this registrant on
a ■status unknown" list. 2) If one wishes to revoke this
registration, a "Lobbyist Withdrawal■ form must be filed with the
Clerk to the Board. 3) Annual Registration Fee is $25.00 per
Lobbyist according to Ordinance 99-22