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2021/2022 Collier County Clerk of Courts Expires 040' 3299 Tamiami Trail E. (Cler 's office only) Suite 401, Bldg. F, 4th Floor Naples, Florida 34112 BOARD OF COUNTY COMMISSIONERS LOBBYIST REGISTRATION FORM NameRobert D. Pritt Date2/22/22 Business Name Robert D. Pritt, Attorney Business Address 25070 Ascot Lake Court City Bonita Springs State FL Zip Code 34134 Business Telephone 239.292.2147 Contact Person Robert D. Pritt Lobbyist E-mail robertdpritt@gmail.com 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 Luc Goemaere 2, Name Address 3355 19th Ave.SW Address City/State Naples FL Zip 34117 Y p City/State Zip 3. Name 4. Name Address Address City/State Zip City/State Zip (ATTACH ADDITIONAL CLIENT SHEETS,IF NECESSARY) State of Florida CD County of Collier ,/l/- Lobbyist Signature 7 This registration yips. sworn or affirmed) and subscribed before me this /. day of -_�� , 20 via"bY Kr} Personally Known BY lAWA' ": _, Produced ID Deputy C,15rk/Nor P blic Type of ID Produced Revised:08/2019 Receipt# 008535992 3/10/2022 1:38:34 PM ,,;;k ;,1 Crystal K. Kinzel Clerk of the Circuit Court and Comptroller -' ,ai 0 gig— @— ,, , (= g,-, gc,-_ -pa Customer Deputy Clerk Clerk Office Location ROBERT D. PRITT BMR CASHIER Collier County Govt. Center ROBERT D. PRITT, MinutesandRecords@CollierClerk.co Building F, 4th Floor ATTORNEY m 3299 Tamiami Trail East, Suite 25070 ASCOT LAKE CT 239-252-2646 401 BONITA SPRINGS, FL 34134- P.O. Box 413044 1962 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# 1012 ($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. ©001:111®Ta® g0EO Page 1 of 1