2002/2003
,-: Lf 3 (JO (J
COLLIER COUNTY
3301 Tamiami Trail East- F-f
Naples, Florida 34112
BOARD OF COUNTY COMMISSIONERS
LOBBYIST REGISTRATION FORM
NAME~lcXH( '[_ G.:n~~~Mftt-.J DATE ;)..-b-D5
BUSINESS ADDRESS F -ec.C?, "1..0 M (C S I ~V\. C. -
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NAMES AND BUSINESS ADDRESS OF EACH PERSON OR ENTITY REPRESENTED:
1)
2)
ATTACH ADDITIONAL SHEETS AS MAY BE N CESSARY
signature
STATE OF FLORIDA
COUNTY OF COLLIER
~"?'*~: ,;:-~~:;~
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The fOregoinJ-registrati~~as sworn to and sUbs~rib~ '~. i~~
this the ~ _ day of ~'''''l ~03 ,by . .
who is personally known to me o~~ho has pro~ce~
~;;).,.~ _ 0 as identification and who di ~ ta~~ ~~;~f,~.:
~ ~.~ 0 I-- '-.....,:..;
? ". & . ()...... A 0 ~. ..' ... - . 4!J) :1";j.}' .
BY: tJl1~~ ..9o/~!r~~~,
Deputy Clerk/Nofla~.:'7.lt8!~~A",~"" ,;'
Please Note: 1) Failure to renew this registration by"f\l.~,t~i
date of October 18t 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 ~egistration Fee is $25.00 per
Lobbyist according to Ordinance 99-22
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: CARYL M
DEPUTY CLERK
Vi: 2899135
CASH:
Me AMT PAID:
RECEIPT: 3876103
DESCRIPTION
NAME:
PAYOR:
REFNC:
02/06/2003
25.00
25.00
AMOUNT
MICHAEL J. TIMMERMAN
MICHAEL J. TIMMERMAN
CTM
LOBBYIST
----------------------------- ----------
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25.00
DEPT: BOARD MINUTES AND RECORDS
Page 01 of 01
TOTAL. DUE:
25.00