2009/2010
Receipt# 007070476
4/21/20103:21:26 PM
Dwight E. Brock
Clerk of the Circuit Court
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Customer
NEILL DORRILL
5672 STRAND CT STE 1
NAPLES, FL 34110-3314
Deputy Clerk
BMR CASHIER
M inutesand Records@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:
Check# 5993
BALANCE DUE:
AMOUNT
$25.00
$25.00
($25.00)
$0.00
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Page 1 of 1
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Board Minutes & Records
3301 Tamiami Trail East
Building F, 4th Floor
Naples, FL 34112
Expires
BOARD OF COUNTY COMMISSIONERS
LOBBYIST REGISTRATION FORM
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Business Address 561:t st"",,-A
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Name
Date
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Business Telephone c;-q L-'~\ \ \\
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PLEASE ATTACH ADDITIONAL SHEETS IF NECESS
State of Florida
County of Collier
The foregoiI)g, regiAtrfltion was sworn to and subscribed before me on this . .'
day of L \ -2 , by , who is personally, 'no ;rt'io,
me or has produced as iden!ificati~n~ aiid:-'- ,..
who did take an oath. B :~~R~ .lfJ ..
~eputy ClerkINotar;~btic :' ..>
Tbe annual registration fee is $25.00 per Lobbyist, according to ColJler Count~:
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
Dwigbt E. Brock, Clerk of Courts (at the address listed at tbe top of tbe form).