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2011/2012 Collier County Clerk of Courts Expires g ° . 3299 Tamiami Trail E. (C1e 's office only) Suite 401,Bldg. F,4th Floor Naples,Florida 34112 BOARD OF COUNTY COMMISSIONERS LOBBYIST REGISTRATION FORM Name John Asher Date 1/30/2012 Business Name KE Talis Park Properties, LLC Business Address 16990 Livingston Road City Naples State FL Zip Code 34110 Business Telephone 239-261-6798 Contact Person John Asher Lobbyist E-mail jasher @kitsonpartners.com Notice for Lobbyists: The annual registration fee is 525.00 per Lobbyist, per Collier County Ordinance No.2003-53,and amended by Ordinance 2004-05 and Ordinance 2007-24. Payments made out to: Collier County Clerk of Courts or Dwight E. Brock,Clerk of Courts (ADDRESS LISTED ABOVE) NAME AND ADDRESS OF EACH CLIENT/ENTITY REPRESENTED: 1.Name KE Talis Park Properties, LLC 2. Name Address 16990 Livingston Road Address City Naples Zip Code 34110 City Zip Code 3. Name 4.Name Address Address City Zip Code City Zip Code (ATTACH ADDITIONAL CLIENT SHEETS,IF NECESSARY) State of Florida County of Collier Lo i s ist Signature This registration was sworn(or affirmed)and subscribed before me this 30th day of, January ,2012 ,by John Asher X Personally Known BY: \ Mkt Produced ID ( : gIEXIS ARYO ► Deputy Clerk/Notary Public Type of ID Produced `' ,•`. Notary Public B State of N Florida 1 ,: L. My Comm. Expires Jan 11,2015 4 %;F'.`p°' ' Revised:09/2011 ,,fit��„ Commission �EE 54752 Receipt#007221240 2/7/2012 2:23:06 PM Dwight E. Brock Clerk of the Circuit Court a if C - a� - aaaaaa �Fe ctK� Customer Deputy Clerk Clerk Office Location JOHN ASHER BMR CASHIER Collier County Govt. Center KE TALIS PARK MinutesandRecords @CollierClerk.co Building F, 4th Floor PROPERTIES, LLC m 3299 Tamiami Trail East, Suite 16990 LIVINGSTON RD 239-252-2646 401 NAPLES, FL 34110-3220 P.O. Box 413044 Naples, Florida 34101-3044 1 Product QUANTITY DESCRIPTION UNIT COST AMOUNT 1 BMR Lobbyist Registration $25.00 $25.00 TOTAL AMOUNT DUE $25.00 Check#7450053 ($25.00) BALANCE DUE $0.00 Note: Disclaimer:All transactions are subject to review/verification. The Clerk reserves the right to correct for clerical errors and to assess or refund charges as needed. CoUOB®Gig® @OG Page 1 of 1