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2003/2004 • ExiP ZOO 3/t COLLIER COUNTY 3301 Tamiami Trail East Naples, Florida 34112 BOARD OF COUNTY COMMISSIONERS LOBBYIST REGISTRATION FORM t�- NAME J e rt /'t - I ":/Vl✓fir 1� DATE I — 12- - U BUSINESS ADDRESS N U (r-%(-O ' e t, L- L I ( 3 1-- o(-" ,n k- Pv-, L 3Li-1 o NAMES AND BUSINESS ADDRESS OF EACH PERSON OR ENTITY REPRESENTED: 1) c le ve, )6 t,,ct C Jct. ( 101 $' t'n dry a (��, dl N (es , C� 3 f/ / 2) S k e_ I `-a t- -t a( 5 PV ev <<e.S, ATTACH ADDITIONAL SHEETS AS MAY BE NECESSARY n Lobbyist Signature STATE OF FLORIDA COUNTY OF COLLIER The foregoin%epistratiop, was sworn to and subscribed before me on this the j day of by ""T�-( J mut i't0 (, who is p onally kern to me or Who has produced 0 —as—ident i f'•c- • on and who di• -ke an oath. BY pavd r ,I Melanie Gonzalez : �R�,j/ erk/ •tary - - is .* '• MY COMMISSION# DD266155 EXPIRE: _ . y Novembell.200; R �: ase+DENGt,OiANMRANFailure to renew this registration by the renewal date of October 1" 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. 3) Annual Registration Fee is $25.00 per Lobbyist according to Ordinance 99-22 N cameo clim)Lf 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 BY: ANN J V#: 3154976 01/14/2004 DEPUTY CLERK CHECK: 25.00 MC AMT PAID: 25.00 RECEIPT: 4140022 DESCRIPTION AMOUNT NAME : JEFFREY A. NUNNER LOBBYIST 25 . 00 PAYOR: JEFFREY A. NUNNER REFNC: APJ DEPT: BOARD MINUTES AND RECORDS TOTAL DUE : 25 . 00 Page 01 of 01