Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
2012/2013
Collier County Clerk of Courts Expires ` 253 t ' 3299 Tamiami Trail E. (Clerk's office only) Suite 401,Bldg. F,46 Floor Naples,Florida 34112 BOARD OF COUNTY COMMISSIONERS LOBBYIST REGISTRATION FORM Name oh Mohelr Date 60111 15 12-0 13• Business Name Cc,c''sex �f�n C-L( cc ��p U�-S�" O r I C. Business Address 145-o `",err i t City State Fl_ Zip Code 3 t) @C) Business Telephone&1 403 42 0cD Contact Person ' iJ■(--) Mond- Lobbyist E-mail rob e corrservc&r eit1 1 orr 1 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 and Ordinance 2007-24. Payments made out to: Collier County Clerk of Courts or Dwight E. Brock, Clerk of Courts (ADDRESS LISTED ABOVE) NAME AND ADDRESS OF EACH CLIENT/ENTITY REPRESENTED: 1.Name r, .-.& . , , g , * 2. Name Address 14 5d (Y15,_(y ibve Jv i iL) Address City Zip Cod e3412-6 City Zip Code 3. Name 4.Name Address Address City Zip Code City Zip Code (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 154-1-/ day of, 3-‘44 , 20 13 ,by Rob Nvht?r - ----- , O-fr�tJp'loLb V Personally Known ( `e,r/V, MARGARET AN bt3-- Produced ID Notary Public-State of Fbrida Deputy Clerk/Notary Public Type of ID Produced ;,ot, My Comm.Expires Nov 12,2013 ,, `�t Commission DO 939945 Bonded Through National Notary Assn. ' Revised:08/2011 • Receipt# 007361103 7/23/2013 2:55:05 PM t»ti,�<<),;_,� Dwight E. Brock Clerk of the Circuit Court �rFi it .iri �/ O _ - \�CC?7 a � ) Customer Deputy Clerk Clerk Office Location ROB MAHER BMR CASHIER Collier County Govt. Center CONSERVANCY OF SW FL MinutesandRecords @CollierClerk.co Building F, 4th Floor 1450 MERRIHUE DR m 3299 Tamiami Trail East, Suite NAPLES, FL 34102-3449 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#9638 ($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. ©0DD000QgOEfu Page 1 of 1