2008/2009Dwight E. Brock
Clerk
BY: ANN J
DEPUTY CLERK
RECEIPT: 5644057
NAME : DAVID DEANS
PAYOR: DAVID DEANS
REFNC: APJ
County of Collier
CLERK OF THE CIRCUIT COURT
COLLIER COUNTY COURTHOUSE
3301 TAMIAMI TRAIL EAST
P.O. BOX 413044
NAPLES, FLORIDA 34101-3044
ORIGINAL
OFFICIAL RECEIPT
When Validated
DEPT: BOARD MINUTES AND RECORDS
DESCRIPTION AMOUNT
LOBBYIST25 00
TOTAL DUE: 25.00
Page 01 of 01
DDT ( D
Board Minutes & Records
3301 Tamiami Trail East
Building F, 4th Floor
Naples, FL 34112
Expires
BOARD OF COUNTY COMMISSIONERS
LOBBYIST REGISTRATION FORM
Name D76QN S Date �, -3 65
Business Address 4-S Z 5o 142 I) e=Y i2a 4D
d v l a,,,, K-v FL 3 2' I O
Business Telephone 4-o7-(,4-)"l a`7 5 E-Mail bF—Q.azo S @ PSI, C0 �^-
NAME AND ADDRESS OF EACH PERSON OR ENTITY REPRESENTED:
1). Colt,
2).
PLEASE ATTACH ADDITIONAL SHEETS IF NE'('ESSARY
Lobbyist Signature
State of Florida
County of Collier
The fore oing r gistratior as s or to and subscribed before me on this
day o by who is personally known.to
me or has produced 1.4c as identificption and" "
who did take an oath.
L."
Deputy
The annual registration fee is $25.00 per Lobbyist, according to Collier CdUlfty
Ordinance No. 2003-53, as amended by Ordinance 2004-05 and Ordinailce'200'
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).