2009/2010
Dwight E. Brock
Clerk of the Circuit Court
Receipt# 007056499
3/2/20108:11:20 AM
Customer
JEFFREY A. AHREN
LEGAL AID SERVICES OF
COLLIER COUNTY
4125 TAMIAMI TRL E
NAPLES, FL 34112-6263
@Utm@Uc~u rJ~~C?)CC;;@DL?)ts
Deputy Clerk
BMR CASHIER
MinutesandRecords@CollierClerk.com
239-252-2646
Clerk Office Location
Collier County Govt. Center
Building F, 4th Floor
3301 Tamiami Trail East
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
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Page 1 of 1
Board Minutes & Records
3301 Tamiami Trail East
Building F, 4th Floor
Naples, FL 34112
Expires 9/201D
Business Telephone (Z3tf) 77 r- y n~)-E-Mail
BOARD OF COUNTY COMMISSIONERS
LOBBYIST REGISTRATION FORM
J e-ff;ey ,4. I/-hr-ev1 Date 34;/ 0
Business Address &:Jal /1-1.,/ .seYV--,'e-e oP ~/,I,~r" M-r...-t h
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Name
NAME AND ADDRESS OF EACH PERSON OR ENTITY REPRESENTED:
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PLEASE ATTACH ADDITIONAL SHEETS IF NECESSARY
State of Florida
County of Collier
I) hrJ....
The foregojn~ registration was sworn to and subscribed before me on this c:;:;.<
day of fV\~. 2D/C , by , who is personally known to
me or has produced FL.. I D as identification and
who did take an oath.
Deputy CJerkINotary Pu He
The annual registration fee is 525.00 per Lobbyist, according to ColJier Coon
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).
BY:
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