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2016/2017 Clerk to the Board, Minutes & Records Dept. Expires 09 2017 3299 Tamiami Trail East, Suite#401 (Staff use only Building F, 4th Floor Naples, FL 34112 BOARD OF COUNTY COMMISSIONERS LOBBYIST REGISTRATION FORM Name Mattaniah S. Jahn Date 1/1/17 Business Address 800 Tarpon Woods Blvd Ste E-1 Palm Harbor, FL 34685 727-773-2221 mjahn@thelawmpowered.com Business Telephone E-Mail NAME AND ADDRESS OF EACH PERSON OR ENTITY REPRESENTED: 1). SBA Communications Corp 8051 Congress Avenue Boca Raton, FL 3387 2) Crown Castle 4511 North Himes Avenue, Suite 210 Tampa, FL 33614 (PLEASE ATTACH ADDITIONAL SHEETS, IF NECESSARY) Lobbyist Signature State of Florida County of Collier The foreAtoing registration was sworn to and subscribed before me on this ag day111 of bypersonally-known nown t �� ��`1111 SC ,, CpM eT , `��knQH` v� , who is � �Q�� �R9,o�%� me or has produced as identificatio •:* who did take an oath. a do�o��•. y BY:hiCt 1 y� I , �,`' 'y #FF 974759 Jj�/��lY � 1 v 7r�j dyB°�ded °°(4% ,11. Deputy Clerk/Notary Pub ••. °d�iceno.•*c••k-,, - 1. The annual registration fee is $25.00 per Lobbyist, according to Collier County �� of j im��� �� Ordinance No. 2003-53, as amended by Ordinance 2004-05, Ordinance 2007-24 and Ordinance 2013-39. Please make payment to: Collier County Clerk of Courts or Dwight E. Brock, Clerk of Courts and mail to the address listed at the top of the form. Receipt# 007754588 1/23/2017 4:09:25 PM Dwight E. Brock Clerk of the Circuit Court CO TjliR Customer Deputy Clerk Clerk Office Location MATTANIAH S. JAHN BMR CASHIER Collier County Govt. Center MATTANIAH S. JAHN MinutesandRecords@CollierClerk.co Building F, 4th Floor ESQUIRE, PA - MPOWERED m 3299 Tamiami Trail East, Suite LAW 239-252-2646 401 800 TARPON WOODS BLVD P.O. Box 413044 STE El Naples, Florida 34101-3044 PALM HARBOR, FL 34685- 2000 1 Product QUANTITY DESCRIPTION UNIT COST AMOUNT 1 BMR Lobbyist Registration $25.00 $25.00 TOTAL AMOUNT DUE $25.00 Check# 11076 ($25.00) BALANCE DUE $0.00 Note: Disclaimer:All transactions are subject to review/verification. The Clerk reserves the right to correct for clerical errors and to assess or refund charges as needed. ©CA UrG QQ ❑@CE2 Page 1 of 1