2009/2010
Receipt# 007061547
3/19/2010 3:01 :40 PM
Dwight E. Brock
Clerk of the Circuit Court
@VVO@]CillO I ~C~CGC~D~)Q
Customer
MACDONALD & FLEMING
233 3RD ST N STE 201
SAINT PETERSBURG, FL
33701-3818
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# 1019
BALANCE DUE:
AMOUNT
$50.00
$50.00
($50.00)
$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 q I?O 10
BOARD OF COUNTY COMMISSIONERS
LOBBYIST REGISTRATION FORM
Name F/,?tl6e/h A.[/11 /11~
Business Address ~3:3 3 t'd st. tJ / 51 e . ;).0 I
S+. PefifsbUArqj H- 33701
Business Telephone 7;)7-3;;; 3 - 3!tff? E-Mail ef/em; h~@de.{€J1derf. Dr5
Date
;)-Ir;- /; 0
1 f
NAME AND ADDRESS OF EACH PERSON OR ENTITY REPRESENTED:
1). bePenders 0+ LJild {,'te
;>33 ]rd S-f- rJ J Yt€. ;)-01
Sf. PeJfrSblAA5 FL, 33701
2). befel1derf of cui/d kle
1/30 171h S-l Nt<J
tJafh/hc1fof) b~ doo30
-
PLEASE A TT ACH ADDITIONAL SHEETS IF NECESSARY
..
~~
Lobb t Signature /
State of Florida
County of Collier
The fO]~eg~aoon was swo~ to and SAcrib~d before me on this ~ ~ftv
day of r, by -Biza0tth em (Ylq ,who is personally known to
me or has produced as identification and
~ did take an oath~ p
0" ....~ PAIGE G. HARPER
~.. . MY COMMISSION' DO 798813
... .. EXPIRES: June 29, 2012
~"~f'I.~.,,,, BondedThluBudgelH*ySeM:el
Deput Clerk/Notary Public
The annual registration fee is $25.00 per Lobbyist, according to Collier County
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).