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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
Full Name
First Name
Last Name
Business/Firm Name
*
Business Address
Street Address
City
State
Zip
Phone Number
*
Fax
Email
*
II. Principal Information
Full Name
First Name
*
Last Name
*
Business/Firm Name
*
Business Address
Street Address
*
City
*
State
*
Zip
*
Phone Number
*
Fax
Email
*
Date Representation Ended:
Subject Matter:
*
Signature of Lobbyist
Signature of Lobbyist
First Name
Last Name
Email
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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.
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