[City of Sunny Isles Beach] Lobbyist Withdrawal Form

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City of Sunny Isles Beach

Lobbyist Withdrawal Form

Office of the City Clerk, 18070 Collins Avenue, Sunny Isles Beach, FL 33160

Direct Phone: 305-792-1703 Main Phone: 305-947-0606 Fax 305-949-3113

Calendar Year

NOTE:

All Lobbyist and Principal (Client) Registrations automatically expire on December 31 of each year.
A separate Principal (Client) registration is required for each principal (client).
Each person who withdraws as a lobbyist must file a “Notice of Withdrawal” with the City Clerk.
Lobbyist Expenditure Reports must be filed with the City Clerk by January 15 of each year.
Lobbyist Expenditure Reports must be filed even if you have no expenditures for the calendar year.
All lobbyist & principal registration forms, reports, & notices of withdrawal shall be submitted to the City Clerk.

I. Lobbyist Information

Business/Firm Name

Phone Number

Fax

II. Principal Information

Business/Firm Name

Phone Number

Fax

Date Representation Ended:

Subject Matter:

Signature of Lobbyist

First Name

Last Name

Choose how to sign

Draw Type

I agree to electronically sign and to create a legally binding contract between the other party and myself, or the entity I am authorized to represent.