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2022/2023 Collier County Clerk of Courts Expires OJ9O3 3299 Tamiami Trail E. (clerk aee only) Suite 401,Bldg. F, 4'Floor Naples, Florida 34112 BOARD OF COUNTY COMMISSIONERS LOBBYIST REGISTRATION FORM NameSheila M. Lake Date8/23/22 Business Name Lake Law Firm, P.A. Business Address 475 Central Avenue City St. Petersburg State FL Zip Code 33701 Business Telephone 727-592-1812 Contact Person S S. Lake Lobbyist E-mail smlake@lakelawfirmpa.com Notice for Lobbyists: The annual registration fee is $25.00 per Lobbyist, per Collier County Ordinance No. 2003-53, and amended by•Ordinance 2004-05, Ordinance 2007-24 and Ordinance 2013-39. Please make payment(s) to: Collier County Clerk of Courts & Comptroller. (Mail to the address listed at the top of the form) NAME AND ADDRESS OF EACH CLIENT/ENTITY REPRESENTED: 1. Name Capri Community, Inc. 2. Name Address 338 Capri Blvd Address Naples, FL zip34113 City/State Zip y 3. Name 4. Name Address Address City/State Zip City/State Zip (ATTACH ADDITIONAL CLIENT SHEETS,IF NECESSARY) State of Florida a_,' � C_ Q� `'c County of Collier Lobbyi t Signature This registration was sworn (or affirmed) and subscribed before me this 23rd day of August 2022 by Sheila M. Lake X Personally Known BY: / l ll Produced ID Depu Cler otary Public Type of ID Produced o NATHAN TAMULONIS r°r MY COMMISSION#HH118588 I EXPIRES:APR 19,2025 Revised:08/2019 2t Doede t through 1st State Insurance Receipt# 008614926 9/1/2022 7:53:33 AM Crystal K. Kinzel \ Clerk of the Circuit Court and Comptroller it ogo''`c ° g _ Customer Deputy Clerk Clerk Office Location SHELIA M. LAKE BMR CASHIER Collier County Govt. Center LAKE LAW FIRM, P.A. MinutesandRecords@CollierClerk.co Building F, 4th Floor 475 CENTRAL AVE m 3299 Tamiami Trail East, Suite ST PETERSBURG, FL 33701- 239-252-2646 401 3859 P.O. Box 413044 Naples, Florida 34101-3044 1 Product QUANTITY DESCRIPTION UNIT COST AMOUNT 1 BMR Lobbyist Registration $25.00 $25.00 TOTAL AMOUNT DUE $25.00 Check#001741 ($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. ©o0011®11'©U@g0EO Page 1 of 1