2002/2003
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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
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BY: MARIE C
DEPUTY CLERK
C' -"SH'
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25.00
25,00
Mr'
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RECEIPT: 3943184
DBSCRIPTION
AMOUNT
=============================
----------
----------
25.00
NAME :
PAYOR:
REFNC:
KIMBERLY ANN SCHLACHTA
KIMBERLY ANN SCHLACHTA
MJC
LOBBYIST
/
DEPT: BOARD MINUTES AND RECORDS
TOTAL DUE:
25.00
Page 01 of 01
5-i40CO
(,:QLLIER COUNTY
3~Ol !amiami Trail East
Naples, Florida 34112
BOARD OF COUNTY COMMISSIONERS
LOBBYIST REGISTRATION FORM
NAME
J\iYl')~n So Jdilt'}z.J4
BUSINESS ADDRESS j?j)~JClI\I) f.i\Vlf1)y)V\I7(Vl~1
, -11Doo Mf1-m ~wcnl # 4
I
~A M.~lVS I R-- 33<1 \ 7-
DATE may 2) ;?cc:s
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NAMES AND BUSINESS ADDRESS OF EACH PERSON OR ENTITY REPRESENTED:
1)
2 )
ATTACH ADDITIONAL SHEETS AS MAY BE NECESSARY
. g~/L/~
~~ist Signature
STATE OF FLORIDA
COUNTY OF COLLIER
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The foregoing registration was sworn to and subscribed befo'~e me on', ,
this the ~ no(.. day of "-rruuf &< O~ , by.,J>t... -#-5 '.J.;j..'~f'j{)'r(:cf'7~O,:, .
who is person,ally known to me or who has produced .::' . : '.~ . ,,' ", ::<. ,
as ident if iea Hon an~ who d~ t,,;ke {a~ 00. lih .' . ": " :
BY:~ :/!.c",-
Deputy Clerk/Notary "~ubl,~.e
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Please Note: 1) Failure to renew this registration by the"'re:n.ewa,(,
date of October 1st will result in the placement of this regi~t~~nt on
a Rstatus unknownR list. 2) If one wishes to revoke this
registration, a RLobbyist WithdrawalR form must be filed with the
Clerk to the Board. 3) Annual Registration Fee is $25.00 per
Lobbyist according to Ordinance 99-22