2010/2011
Clerk to the Board, Minutes & Records Dept.
3299 Tamiami Trail East, Suite #401
Building F, 4th Floor
Naples, FL 34112
Expires
BOARD OF COUNTY COMMISSIONERS
LOBBYIST REGISTRATION FORM
Name ~t>iX-r ,). Ml-<. ti-LC- ""<- ,P-/TTLP
Date :2 ~ fS - ).:; )1
Business Address jV\~ { k C-c.AY
fu. {JJf '~6,I) ~r /)
Business Telephone 2 3 ~ f 2 1 ~? 7 ('
A:s5 () {t"-- ~ . ~c
--r:-s J I ~( 3y) 'Ie
E-Mail ~ {VI t.L (k u-c @. c::; ~ e.. [
I ' Cd~
NAME AND ADDRESS\QF EACH PERSON OR ENTITY REPRESENTED:
\.) ~ L~'Lc!J
1).
2). fJ
(pLEASE A TT ACH ADDITIONAL SHEETS, IF NECESSARY)
~
L~bYist Signature
State of Florida
County of Collier
The foregping registration was sworn to and subs(:ribed before me on this{~'"
day of I'" " , by " who is p~J:S@ftallykD.own to
me or has produced 1 C ~( . ,.' ",~';:tt~"'ilieiittfication and
. ," . '.;1.' ... ......... '-:""0 '.
who dId take an oath, " ""'" /:j.J.,.......!, .... v
.~\C :'\;':'J'~.'" ;,:~:\.,;,J}..<;_:.', '~
,r :.f.~~ 'C',\' l,n~ . .:; /
BY," / \:...:' \"l,.'~ \ .'. ,. \
'; ',;:-2..\ ;<_"/:-' ,
. .
DepJti.~I~rWoi~'Pub1ic
;- ,-~ " . < "
The annual registration fee is $25.00 per Lobbyist, accordingt;to.lie..~ounty
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).
J
Receipt# 007137158
2/8/2011 1 :57:39 PM
Dwight E. Brock
Clerk of the Circuit Court
@VVO@J([)O ~C~CGC~D~G
Customer
ROBERT MULHERE
MULHERE & ASSOCIATES
PO BOX 1367
MARCO ISLAND, FL 34146-
1367
Deputy Clerk
BMR CASHIER
M inutesand Records@CollierClerk.com
239-252-2646
Clerk Office Location
Collier County Govt. Center
Building F, 4th Floor
3299 Tamiami Trail East,
Suite 401
P.O. Box 413044
Naples, Florida 34101-3044
1 Product
QUANTITY
1
DESCRIPTION
BMR Lobbyist Registration
UNIT COST
$25.00
TOTAL AMOUNT DUE:
Cash Tendered:
BALANCE DUE:
AMOUNT
$25.00
$25.00
($25.00)
$0.00
(G@[j[jD@rr(G[j@rrD:fo @@[J[f[]
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