2009/2010
Collier County
3301 Tamiami Trail East
Naples. FL 34112
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1I0ARD OF COUNTY COMMISSIONERS
LOBBYIST REGISTRATION FORM
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Lobbyist Signature
PLEASE ATTACH ADDITIONAL SHEETS IF NE
State of Florida
County of Collier
The for~oM registration was sworn to and subscribed before me on this
day of ~D~~r) '2t:>lf1. bylb _ r<~~ , who . r~Gnau)t, own to
me or has produced ' " '.' ca' on and
who did take an oath. . ' . '.1~ ":". ,,<
. .~ -~...
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BY:
Deputy e Public
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The annual registration fee is $25.00 per Lobbyist, according to COI':~~~nty
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).
Receipt# 007027345
10/15/20093:43:06 PM
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Dwight E. Brock
Clerk of the Circuit Court
Customer
MICHAEL REAGEN
NAPLES CHAMBER OF
COMMERCE
10391 REGENT CIR
NAPLES, FL 34109-1592
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# 1747
BALANCE DUE:
AMOUNT
$25.00
$25.00
($25.00)
$0.00
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