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2004/2005 BY: ANN J DEPUTY CLERK RECEIPT: 4361711 NAME: STEVE SAMMONS STEVE SAMMONS PAYOR: REFNC: APJ County of Collier CLERK OF ~HE CIRCUIT COURT COLLIER COUNTY COURTHOUSE 3301 TAMIAMI TRAIL EAST P.O. BOX 413044 NAPLES, FLORIDA 34101-3044 ORIGINAL OFFICIAL RECEIPT When Validated DESCRIPTION ~.~.~" :,'", .'~' ,.....' ',' "C' '"'.''' \iJ;.., ',' '.;.....:... "','. ~r 'jtf; .33706'16 iO/l,3/2QC!!~ CHECh~ ',1r Ar1T ,'AID; )=:: iT! :-..: ~ ......- .25~ DO AMOUNT ----------------------------- ---------- ----------------------------- ---------- 25.00 LOBBYIST DEPT: BOARD MINUTES AND RECORDS Page 01 of 01 TOTAL DUE: 25.00 COLLIER COUNTY 3301 Tamiami Trail North Naples, FL 34112 BOARD OF COUNTY COMMISSIONERS LOBBYIST REGISTRATION FORM BUSINESS: ~~A~ W l V'OON t,U(...\.EJL. DATE: _100 Oe,. 04- ~ LA~b~cA~ ~akrec.1Vt2f; NAME: NAMES AND BUSINESS ADDRESS OF EACH PERSON OR ENTITY REPRESENTED: 1) 'DI"O~Th BoIME% I L 0 'Po ~MM.ll;;(;,e SQl)~6 oFFICe ~ :o.+c:;C\ pr~€ l2t t::x'-,P PMOh. tJA.P~ ft- ~\I4 2) ~ "t;:l6V6I...o~~~ 41;01 11ioaM\~1 11'AIl,... No, sre -lCS '300 I'1~PLe~ FL. ] We "3410'3 ATTACH ADDITIONAL SHEETS AS MAY BE NECESSARY. ~"' ~) JJtAS~It=" t:eV6\..O~J LlL l' $0 GrM.LeiVtI~ co\1(tT sre 3110 , ~fll.ES Ft. '5410'1 - Signature STATE OF FLORIDA COUNTY OF COLLIER The foregoing registration was sworn to and subscribed before me on this the 8 day of ()~'\. ;;lool\-, by S{e\.\EI\ \:I. SQ..rnmol\lS who is personally known to me or who has produced \''') 0 NE' as id id take an oath. ....'~ MARLENE R. SALE ~".1 MY COMMISSION" DD 125860 "tflf.,..<<fF EXPIRES: August 6, 2006 1-l1JC}3-NOTAR'f R. Notay SeM<:e & Bonding, Inc. BY: m cu. Q~ .,\ILL --R. bale Deputy Clerk/Notary Public please Note: 1) Failure to renew this registration by the renewal date will result in the placement of this registrant on a ftstatus unknown" list. 2) If one wishes to revoke this registration, a ftLobbyist Withdrawal" form must be filed with the Clerk to the Board.