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HomeMy Public PortalAboutStrenth, Michelle - Registration Form - Orlando HealthCity of Orlando Lobbyist Registration From (One Client Per Registration Form) I. Lobbyist Information: Name: 6A ic.14de_. Mailing Address: tratiL ke YitPU- City 0( LO_PC State: Zip 3 UU LS Email: Phone: /-6►-f'/ 1 C Fax: 3)1— ( 5.0 S9 L2 vviC;VetY `3fi(e,//k+11k e O(la meea ,C' X► ' -� II. Client/Principal Information Name: b(l arcilz 1, Business: 1.X(LQ• 1(`L'Z.� Business Address: `51 NIL" fatkL ,4V' City: Of ILL int State: Is your client: Zip: t.P Corporation [‘.]7 Partnership [ ] Type: Association [ ] Trust [ ] Name: To the best of my knowledge, the above information is correct. I understand that pursuant to City Code sec. 2.191(4), I am required to file an expenditure report on February 1st and August 1st of each calendar year of any lobbying expenditures involving the City during the preceding six month period (January -June, July -December). Signature AA c.k1eA, e S itek— Print a e , I Zlj$ Dat /