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2009/2010 Receipt# 007028937 10/22/20093:21 :02 PM Dwight E. Brock Clerk of the Circuit Court (9)~Km@rJ(glU [~@@@O[J)ts Customer JOHN BARLOW H.O.M.E. 4351 GULF SHORE BL VO N NAPLES, FL 34103-2697 Deputy Clerk BMR CASHIER Minutesand Records@CollierClerk.com 239-252-2646 Clerk Office Location Collier County Govt. Center Building F ,4th Floor 3301 Tamiami Trail East P.O. Box 413044 Naples, Florida 34101-3044 1 Product QUANTITY 1 DESCRIPTION BMR Lobbyist Registration UNIT COST $25.00 TOT AL AMOUNT DUE: Check# 1107 BALANCE DUE: AMOUNT $25.00 ~ $25.00 ($25.00) $0.00 Page 1 of 1 [g@D D D@u[gDG~ufko ~@WD Board Minute:; & Records 3301 Tamiam Trail East Building F, 4th Floor Naples, FL 34112 . '--j [b- J,1 ft;~. Expires q /,;}o 10 Business Addlress BOARD OF COUNTY COMMISSIONERS LOBBYIST REGISTRATION FORM ~ .0. M - ~. Date II9/Z1 L O~ 36t ~l.( $hol<.e- ~vO. AJ' ~e.sl-&IltkP-/~A.J IJP~fle-> I VL tr ~{Or ! .Le 7[} . I f '61J ~ - . ~ AJ'L-1:- Business Telephone k-?7 ~ T I~~ ::.nL1-Mall~~ Jk:)aJI1 cQ. eY'tl/a...y- NAME AND ADDRESS OF EACH PERSON OR ENTITY REPRESENTED: l1Du.si..x; oeorfUVt11e.s M~A- ~ <2~r-L { ()<- . '1~(1 (f ~OYe- /?7lJP. J. RdltyWU- fct ,J IJAlle~ f/L-- ~i(oJ Name 1). 2). State of Floriida County of Collier The foregzttregistrati02 was sworn to and subscribed before me on this db) /I ~ day of lo/ier; tto ), by , who is personally known to me or has produced h f) L as identification and who did take an oath. (" BY: .... --::: .: .. '.- Deputy ClerkINotary p~ c The annuall'egistration fee is $25.00 per Lobbyist, according to Collier County Ordinance No. 2003-53, as amended by Ordinance 2004-05 and Ordinance 2007-24. Please make payment and mail to: Collier County Clerk of Courts or Dwight E. Brock, Clerk of Courts (at the address listed at the top of the form). , "