2009/2010
Board Minutes & Records
3301 Tamiami Trail East
Building F, 4th Floor
Naples, FL 34112
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1).
BOARD OF COUNTY COMMISSIONERS
LOBBYIST REGISTRA nON FORM .. J
Name <JCrIl 1'5 '> [<51 . _ Date 7!s; ( (J
Business Address /0(/(/1 7CfWtI~utl (r. At. ~ ~(/l Ie> ~ /
/
IV;p/~/.rL $ Y"tt/-L .
Business Telephone ~51- ;2b ~- ZiS2. E-Mail J5 It:.s-.~(ci) Sl'//~, es>%,
NAME AND ADDRESS OF EACH PERSON OR ENTITY REPRESENTED:
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PLEASE TTACH ADDITIONAL SHEETS IF NECESSARY
2).
State of Florida
County of CoUier
The fore oing registration was sworn to and subscribed before me on this 2~'""'" ""'" 0.,
day of . 2PlO, by , who is personally known to '0"1'1,
me or has oduced FL- 1>v as ident~ficatjql}oatfd"'... "',"
who did take an oath. , .' .>, . ~
Deputy ClerkINotary PubJ'c ' ,
The annuaJ registration fee is $25.00 per Lobbyist, according to Comer County' "
Ordinance No. 2003-53, as amended by Ordinance 2004-05 and Ordinance 2007-24.
Please make payment and maiJ to: Comer County Clerk of Courts or
Dwight E. Brock, Clerk of Courts (at the address listed at the top of the form).
Receipt# 007094885
7/28/20108:55:20 AM
Dwight E. Brock
Clerk of the Circuit Court
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Customer
JAMES H. SIESKY
SIESKY
1000 TAMIAMI TRL N STE
201
NAPLES, FL 34102-5481
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:
Cash Tendered:
BALANCE DUE:
AMOUNT
$25.00
$25.00
($25.00)
$0.00
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