2020/2021 Collier County Clerk of Courts Expires o
3299 Tamiami Trail E. (Clerk's ice only)
Suite 401, Bldg. F,4"' Floor
Naples, Florida 34112
BOARD OF COUNTY COMMISSIONERS
LOBBYIST REGISTRATION FORM
Name Ciit=-j-t S sw►ti-'h -------_-------- Date_.._1-1 "i1._- 2- -----._----
Business Name _ei44/5 _mL, J1cJ
Business Address 50 f S'0 �_i--u$i, L--_
City _. -Le _ State 1"-c_)icr`S Zip Code
Business Telephone(139)7 77 876 Contact Person
Lobbyist E-mail eat. e � a.&L. r Okri
Notice for Lobbyists: The annua 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 County Clerk of Courts&Comptroller.
(Mail to the address listed at the top of the form)
NAME AND ADDRESS OF EACH CLIENT/ENTITY REPRESENTED:
1. Name_ Q1Vuft_ k�_�, 1 2. Name
Address into qtikS -,s. (J , Address
City/State lU a pr �' S F j Zip 34 II 7 City/State Zip
3. Name_ � 4. Name IVAAddress Address
City/State Zip City/State Zip
(ATTACH ADDITIONAL.CLIENT SHEETS,IF NECESSARY)
60811
State of4���'���tAs
County of -I-A �` tOra-
Lobbyist Signature
This registration was sworn (or affirmed)and subscribed before me this i•C;• It day of_APR) ,
2024 _by__CV_STJ.S_S E_. -
Personally Known BY: lagthadif
Produced ID De.uty Clerk/Notary Public
Type of ID Produced ri0tRS �iG47CE luuj:N0taraexas
sed:0812019
a +` Comm,Expires 06-03.202V'
nu,,, Notary ID 7541494
Receipt# 008374515
4/26/2021 4:07:02 PM
�"��,\ER CO(i�T Crystal K. Kinzel
� � Clerk of the Circuit Court and Comptroller
`P,. ,cow 0T3_
0 o 1 0
OF THE CIR�J`� g � g— — �g g jD1 CR
Customer Deputy Clerk Clerk Office Location
CURTIS SMYTHE BMR CASHIER Collier County Govt. Center
CURTIS SMYTHE MinutesandRecords@CollierClerk.co Building F, 4th Floor
504 SAGEBRUSH CT m 3299 Tamiami Trail East, Suite
ALEDO, TX 76008-1349 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
Check# 134 ($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.
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