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Notice Of Withdrawal Of Lobbyist Registration - Florida

Notice Of Withdrawal Of Lobbyist Registration Form. This is a Florida form and can be used in Lobbyists Miami-Dade Local County .
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MIAMI-DADE COUNTY NOTICE OF WITHDRAWAL OF LOBBYIST REGISTRATION Section 2-11.1(s) - Code of Miami-Dade County, Florida Please Type or Print in Ink Note: On or before July 1 of each year, every lobbyist must file an expenditure statement with the Clerk of the Board of County Commissioners for the preceding calendar year, regardless of the level of activity of the lobbyist, but only if the lobbyist has incurred expenses during the reporting period. st Lobbyist Name: Mr/Ms Last Name First Name Mi. Business/Firm Name Address ____________________________________ City ________________________ State _____________ Zip Check here only if you are withdrawing as a Lobbyist and from all representations, otherwise continue as required. Principal Represented: Business/Firm Name Address ____________________________________ City ________________________ State _____________ Zip Date Representation Ended: __________________________________________________________ Subject Matter: ___________________________________________________________________________________ __________________________________________________________________________________ Signature of Lobbyist _____________________________________ For Office Use Only: Data Entry Date ___________________________, 20_______. Date: _____/_____/_____ Entered By _________________________________________________________ (Form Revision Date: 1/16/2013) Clerk of the Board of County Commissioners, 111 NW First Street, Suite 17-202, Miami, FL 33128 Office: 305 375-5137 - Fax 305 375-2484 www.miami-dadeclerk.com/dadecoc/Clerk_Board.asp American LegalNet, Inc. www.FormsWorkFlow.com
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