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2021/2022 Collier County Clerk of Courts Expires CP ��� 3299 Tamiami Trail E. (Clerk's ffice only) Suite 401, Bldg. F, 4th Floor Naples, Florida 34112 BOARD OF COUNTY COMMISSIONERS LOBBYIST REGISTRATION FORM NameGina R. Green, P.E. Date9/20/21 Business Name Gina R. Green, P.A. Business Address 3310 1st Ave NW City Naples State FL Zip Code 34120 Business Telephone 239-348-0500 Contact Person Gina R. Green Lobbyist Email ggreeneng@aol.corn 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 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 WR Real Estate LLP 2. Name Diane K Wanty Trust Address 2806 Laurentide DR Address 785 Bald Eagle DR City/State Marco Island FL Zip 34145 City/State Ann Arbor MI Zip 48103 3. Name Carol Rosenblatt 4. Name Address 1212 Imperial Drive Address City/State Naples FL Zip 34110 City/State Zip (ATTACH ADDITIONAL CLIENT SHEETS,IF NECESSARY) State of Florida County of Collier Lobbyist Signature This registration was sworn (or affirmed) and subscribed before me this day of 20 by Personally Known BY: Produced ID Deputy Clerk/Notary Public Type of ID Produced Revised:08/2019 Receipt# 008452797 9/22/2021 4:15:01 PM ceR Crystal K. Kinzel Clerk of the Circuit Court and Comptroller F EROp THE CI0.<�`� .-.g— U\� O Customer Deputy Clerk Clerk Office Location GINA R. GREEN Martha S. Vergara Collier County Govt. Center GINA R. GREEN P.A. martha.vergara@collierclerk.com Building F, 4th Floor 3310 1ST AVE NW 239-252-2646 3299 Tamiami Trail East, Suite NAPLES, FL 34120-2704 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# 1709 ($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. ©CA[IrlQO® ❑@C Lf Page 1 of 1