2003/2004
County 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: PATRICIA M
DEPUTY CLERK
RECEIPT: 4139137
DESCRIPTION
----------------------------- ----------
----------------------------- ----------
25.00
NAME :
PAYOR:
TIMOTHY L. HANCOCK
TIMOTHY L. HANCOCK
PLM
LOBBYIST
REFNC:
DEPT: BOARD MINUTES AND RECORDS
Page 01 of 01
V#: 3154075
CHECf<:
MC AMT PAID:
TOTAL DUE:
t+- 03~
01/13/2004
25.00
25.00
AMOUNT
25.00
COLLIER,COUNTY
3301 Tamiami Trail East
Naples, Florida 34112
H- 031bD
H1\ru q 12DO~
NAME
BOARD OF COUNTY COMMISSIONERS
LOBBYIST REGISTRATION FORM
-----
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/cJ bCJX 9229
IV~{.c/: rz 31/ u /
.
BUSINESS ADDRESS
NAMES AND BUSINESS ADDRESS OF EACH PERSON OR ENTITY REPRESENTED:
1) Bt-iJ ill [J{.-(3 - At/i~ E: #('-'6 I IL:('
8~J}b;J{e- /1IPL6; ~L(J
.
1/LACr lJ~/ 1k~71f'T~ J LC,
"~7/w:;. ff""liTM'::' INT.
;l/y~ ~t"J7~ {_
1J..ft771v07IvG> (b,1J4IfJNt 71'6'7
AT~A~H ADDITIONAL SHEETS AS MAY BE NECESSARY
IV ~ /:l;p6fEr .I /Jff-zt/lr ~,,',~ -;/ ,/ / '_J
g;if'~~rx ~qp
/Lobbyist Signature
STATE OF FLORIDA
COUNTY OF COLLIER
The foregoing registration was Sworn to and sUbs<rrib~d, be, ore mean
this the l~ day of ::::ra.r')~~ 2.co.I_, by \;'~_ L.' _~ "
who is personally known to me 0:1: who has produced \\lCl.r-!;, 1\CQr6e.
~522-g12-b6-410~ as identification and who did take an oath.
'.
BY:
'd-mn
Deputy Clerk/Notar Pub+ic
Please Note. 1) Failure to renew this registration by the renewal
date of October 1.t will result in the placement of this registrant on
a Rstatus unknownR list. 2) If one wishes to revoke this
registration, a RLobbyist Withdrawaln form must be filed with the
Clerk to the Board. 3) Annual Registration Fee is $25.00 per
Lobbyist according to Ordinance 99-22