2010/2011
Board Minutes & Records
3301 Tamiami Trail East
Building F, 4th Floor
Naples, FL 34112
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BOARD OF COUNTY COMMISSIONERS
LOBBYIST REGISTRATION FORM
Name
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Date
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Business Address
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Business Telephone l.~ (, - b'Z.-t'.-IIl-J ~ E-Mail-f) b\2.0w,.J @ 'YA f'AMo'^" l Ii) . (Ot\.
NAME AND ADDRESS OF EACH PERSON OR ENTITY REPRESENTED:
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PLEASE ATTACH ADDITIONAL SHEETS IF NECESSARY
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~bYist Signature
State of Florida
County of Collier
The foreg~1stration was sworn to and subscribed before me on this .. ,........... "....",.
day of \ ( 2010, by , who is personally.1mown.to.......~ >,~/
me or has produced"JX-- as iden~nca!iml!~~ ...~:,.I?'~:}~
who did take an oath. . : . !.'J\ . '0 !'} '.
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Deputy ClerkINgkfJ:Yi"pulJ,r . .
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The annual registration fee is 525.00 per Lobbyist, according to Collier Coun~.~c' E '?J, ::
Ordinance No. 2003-53, as amended by Ordinance 2004-05 and Ordinance 2007;.24J""""
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).
Receipt# 007105741
9/14/20109:19:52 AM
Dwight E. Brock
Clerk of the Circuit Court
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Customer
JEFFREY JOFINSON &
JAMES BROWN
ROETZEL & ANDRESS
850 PARK SHORE DR
NAPLES, FL 34103-3587
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
2
DESCRIPTION
BMR Lobbyist Registration
UNIT COST
$25.00
TOTAL AMOUNT DUE:
Check# 909977
BALANCE DUE:
AMOUNT
$50.00
$50.00
($50.00)
$0,00
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