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2007/2008 Dwight E. Brock Clerk BY: ANN J DEPUTY CLERK RECEIPT: 5289013 NAME : AMBER CROOKS AMBER CROOKS PAYOR: 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 DESCRIPTION G t"JlOSD {?xp. qlD~ '.t#: 4277209 4 r, :' A ."'!- ,I -inn..,. .::. U/ .:.i.... L':-'l....: f CHEC~< o""!C" ~,., .' " 1:1' ...- ~, .".;'-. CT AMT PAID 25.00 AMOUNT ----------------------------- ---------- ----------------------------- ---------- 25.00 LOBBYIST DEPT: BOARD MINUTES AND RECORDS TOTAL DUE: 25.00 Page 01 of 01 Collier County 3301 Tamiami Trail East Naples, FL 34112 Expires q }71>D~ BOARD OF COUNTY COMMISSIONERS LOBBYIST REGISTRATION FORM Name -=t3::rhJ3 E ~ (',~CO IL5 Business Address \ '*~() Me f r; h v-e 1) 'f'. Date \ 0 I I 2.1 c 1- I ~k) ('PL- 3'-f lOL ei f--28'=> . Business Telephone .:z 31, 2~ 7., 07,0 Y E-MaIl 0 mh e V' c- @ ( "-"",<'P <Y",,^L(j- , <rt J NAME AND ADDRESS OF EACH PERSON OR ENTITY REPRESENTED: 1). Ctrn 5-t'v' VlA./n.(;1 ~{ Slt1/ PL /Y"5D /VlY'rrt ohv-e D (' . N~1L),' R- '3 Y(~7~ 2). PLEASE A TT ACH ADDITIONAL SHEETS IF NECESSARY O_l~C--- Lobbyist Signature State of Florida County of Collier The foreg~~Il$ rriistration was sw rn to and subscribed before me on this \ 0-"'" day of \ (:TW\ D:t 1~"\)b1r , who is personally known to me or has produced '- as identification and who did take an oath. By:_(L", J.!~ Deputy Cle; Pu.- The annual registration fee is $25.00 per Lobbyist, according to Collier County Ordinance No. 2004-05