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2003/2004 BY: PATRICIA M DEPUTY CLERK RECEIPT: 3863362 NAME : JEFFREY A. WILSON JEFFREY A. WILSON PAYOR: REFNC: PLM 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 DESCRIPTION -. - - - - ~ -,.. ,.. . :.':;C:::::UJ ',,,-' tu-4lcm ~ Q(36(03 ,:."," ~ AMOUNT ----------------------------- ---------- ----------------------------- ---------- 25.00 LOBBYIST DEPT: BOARD MINUTES AND RECORDS TOTAL DUE: Page 01 of 01 25.00 COLLIER COUNTY 3301 Tamiami Trail North Naples, FL 34112 BOARD OF COUNTY COMMISSIONERS LOBBYIST REGISTRATION FORM NAME: ~-H\ bJ\ I~,,- BUSINESS: t\)\ \ '{f{\ W\, \ l-e( IJ'{ I Y ~)ll C () \ (;.111 (.Jl -t?)OJ \ (J uCdcl ~Ufuy(s{ Fl~?F1DS NAMES AND BUSINESS ADDRESS OF EACH PERSON OR ENTITY REPRESENTED: 1) CCH,t?r C(ln~ C)(,;\,\{rnnun+ DATE: Ct-tu6.er \ \, dDZyL 2) .~\il\~~itr BERNADETTE RABHFOFID I~/~";~ MYCOMMISSIQNIDDOO9122 ",,;'~'"J.' EXPIRES: May 16, 2005 i. "{',ir:,-r,..'(f,;" 6ondtdThruNollryPublloUnd.rwriters ATTACH ADDITIONAL SHEETS STATE OF FLORIDA COUNTY OF COLLIER ~~~s ft~ee:~r~::istr~~~o~f w~s sworn to an who ~ personally known~to me or who has pro as ide'ntification andwhd did take an oath. sUbscr~Q. before me on , by CR f' U \'\G"-' , uced BY: c Please Note: 1) Failure to renew this registration by the renewal date will result in the placement of this registrant on a "status unknown" list. 2) If one wishes to revoke this registration, a "Lobbyist Withdrawal" form must be filed with the Clerk to the Board.