2022/2023 Collier County Clerk of Courts Expires 0q/19-0d;
3299 Tamiami Trail E. (cterce only)
Suite 401, Bldg. F, 46 Floor
Naples, Florida 34112
BOARD OF COUNTY COMMISSIONERS
LOBBYIST REGISTRATION FORM
Name DAN E EAGLE Date 3/28/2023
Business Name BALLARD PARTNERS, INC.
Business Address 201 EAST PARK AVENUE, 5TH FLOOR
City TALLAHASSEE State FL Zip Code 32301
Business Telephone 850.577.0444 Contact Person DANE EAGLE
Lobbyist E-mail dane@ballardpartners.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 VERIZON 2, Name
Address 5055 NORTH POINT PARKWAY
Address
City/State ALPHARETTA, GA Zip 30022 City/State Zip
3. Name 4. Name
Address Address
City/State Zip City/State Zip
(ATTACH ADDITIONAL CLIENT SHEETS,IF NECESSARY)
State of Florida
County of Collier
Lobbyist Signature
This egistration was sworn (or affirmed) and subscribed before me this 2-FT I—{ day of MA12,CA-4
202 by DiolikE. ,uE.,-
Personally Known BY:
Produced ID - -• ►mot Ctoii rslotary Public
Type of ID Produced ;;<�*7.' .; CYNTHIA .DA IS
. ,: MYCOMMISSIO # 148455
•
EXPIRES:July 9,2025
Bonded Thu Notary Public Underwriters
Revised:08/2019
Lobbyist: E Ballard Partners, Inc
Name: Dane Eagle
E-Mail: dane@ballardpartners.com
Date Received Details
4/3/2023 New Registration - Exp. 09/2023