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2008/2009 Receipt# 007010783 8/5/2009 1 :52:09 PM Dwight E. Brock Clerk of the Circuit Court @VVD@.JCIDD ~@@@D~U Customer DAVID L. TETZLAFF NAPLES ZOO, INC. 1590 GOODLETTE FRANK RD NAPLES, FL 34102-5260 Deputy Clerk BMR CASHIER M inutesand 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 TOTAL AMOUNT DUE: Check# 3578 BALANCE DUE: AMOUNT $25.00 $25.00 ($25.00) $0.00 ([;@O 0 O@[j([;O@[jff:ro @@[f[f[) Page 1 of 1 Board Minutes & Records 3301 Tamiami Trail East Building F, 4th Floor Naples, FL 34112 --r:,;~,<lO ~rca- Name BOARD OF COUNTY COMMISSIONERS LOBBYIST REGISTRATION FORM ])I1XIQ L !f-rZ?IJPr /,{tJO 6txJp ~e.I7t?; - ~/"Jf-!i~~JZtJt10 AJIlf~r ~ Date ~61 JI/l--Y () 9 Business Address Business Telephone~6?~ S qOtj A" I ()1- E-Mail NAME AND ADDRESS OF EACH PERSON OR ENTITY REPRESENTED: I!JrpL-fl5 ZOO, Z;f/c 1 ). 2). PLEASE ATTACH ADDITIONAL SHEETS IF NECES State of Florida County of Collier ') 1 ,4 The foreg;ti.og registration was s~om to, and s~seribed before me on this -'^~ - day of 0U~' Joo,! ,byc:!~u, dim C_/iT:L/tZrf ,_who IS personally known to ~or has prod ced _ _. . 'm" as identification and who did take an oath. :............................................. : CAMILLE PiCKeNS : d ~ ~~ C'Axnml 000745897 ~ i a'4l1'.11 Expires 11312012 g BY: .~ ~ . /1, /~~1-- i --q.rt~ FIortda~_..1nc i Dc ut Clc kIN t P hI "lI............................................; . p y , _ r 0 ary u ic The annual re2istration fee is $25.00 per Lobbyist, accordin2 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).