2019/2020Collier County Clerk of Courts Expires zow
3299 Tamiami Trail E. (Clerk's office only)
Suite 401, Bldg. F, 4t1i Floor
Naples, Florida 34112
BOARD OF COUNTY COMMISSIONERS
LOBBYIST REGISTRATION FORM
Name lury av(,coc,� � tj L'j Date 6�1/ 1240
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Business Name Tr Tco.nsps-�c�-I-,on (�o' asu. 6,,ks 4 1,ty_
Business Address Z ?�Z (o O w4,
City ease 60r&I State Zip Code SP 3 34o Y
Business Telephone Contact Person yctry QYkot'(
Lobbyist E-mail -�r- ran.s . Aa+
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 REPRESENTED:
1. Name 2. Name
Address
City/State
3. Name
Address
City/State
Address
Zip City/State
4. Name
Address _
Zip City/State
(ATTACH ADDITIONAL CLIENT SHEETS, IF NECESSARY)
State of Florida
County of Collier
Lobbyist Signature
Zip
Zip
This registratio was sworn (or affirmed) and subscribed before me this day o ,
20, by J
Personally Known BY:
Produced ID Deputy Cleek;/N r-y ub is
Type of ID Produced fl, -D - ` �--
Revised: 08/2019
Receipt# 008224053
6/11/2020 10:21:24 AM
,XeRcot, Crystal K. Kinzel
��- Clerk of the Circuit Court and Comptroller
Oho g � 0 0
Customer
Deputy Clerk
Clerk Office Location
YURY BYRAU
TR TRANSPORTATION
BMR CASHIER
MinutesandRecords@CollierClerk.co
Collier County Govt. Center
Building F, 4th Floor
CONSULTANTS, INC.
2726 OAK RIDGE COURT
m
239-252-2646
3299 Tamiami Trail East, Suite
CAPE CORAL, FL 33904
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)
Note:
BALANCE DUE $0.00
Disclaimer: All transactions are subject to review/verification.
assess or refund charges as needed.
The Clerk reserves the right to correct for clerical errors and to
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