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2008/2009 Receipt# 007008643 7/27/20092:36:49 PM ~"Q~;;'>1'\ :;;( '.". \/\;\:2\) ~ :1't~ ~, CO r.Jpl'lJEn\l.C""',(' Dwight E. Brock Clerk of the Circuit Court @vao@DCIDD C~C@CG@D~U Customer JOHN F. SOREY 220 GULF SHORE BLVD N NAPLES, FL 34102-8450 Deputy Clerk BMR CASHIER Minutesand Records@CollierClerk.com 239-252-2646 Clerk Office Location Collier County Gov!. 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# 659 BALANCE DUE: AMOUNT $25.00 $25.00 ($25.00) $0.00 ~Co) ODD @fl~ O@{f{}:{o ({g@[fff[j Page 1 of 1 Board Minutes & Records 3301 Tamiami Trail East Building F, 4th Floor Naples, FL 34112 Expires 1/ oq 5- s~ 5G() BOARD OF COUNTY COMMISSIONERS LOBBYIST REGISTRATION FORM Name -::TV'/'--. I:::. .s~ '0<7 W Date Z:;17 ,)-i ......_:;- Business Address )?- f;? t:, ..-1/5 f",,--e-. 1'7/-- /. /t'O fI/C-<--p 4J F I- :341/ D 2- y Business Telephone 2-X7.-..~t'-/.r.r= E-Mail {O"-~7 ~ ct,-,., w.co.-.c-"<J'7;. .-7<97 NAME AND ADDRESS OF EACH PERSON OR ENTITY REPRESENTED: I). IV'RV p( e- -' ;Z (70 , I s '1 {/ t; c?Q / / e '1'7& P r~... k /?,,---/ IV ""'-,-:ole " j::: L- ..? I-f / (;7 2- II' . 2). PLEASE ATTACH ADDITIONAL SHEETS IF NECESSARY ~,p-~~~ obbyist Signature State of Florida County of Collier The foregoing registration was sworn to and subscribed hefore me on this " ~l i-~ day of -JJ[U. ~ , by__ . __ , who is personally known to me or~. '_, ---- as identification and who did take an oath. ...Y--- The annual registration fee is $25.00 per Lobbyist, according to Collier C 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).