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2015-rTheCherinGroup Date Stamp City of Long Beach LOBBYIST RENEWAL FORM INSTRUCTIONS 1� 1. Fill out form 2. Sign and date 3. File with: Long Beach City Clerk's Office 333 W. Ocean Blvd. Long Beach, CA 90802 Tel. 562 570-6101 O This is the Renewal Registration Report due January 15 for: Lobbyist Name: Alex Cherin /The Cherin Group Filer ID Number: C. (— \3 ,, G a- 3 Renewal for Calendar Year: 2015 Registration Fees: Persons subject to the registration requirements of this ordinance shall pay an annual fee of one hundred dollars ($100.00). The applicable fee is due at the time of registration renewal. Payment will be deemed delinquent thereafter. Late Fees will be assessed on a per day basis in accordance with Long Beach Municipal Code 2.80,and the most recent Fee Schedule approved by Long Beach City Council. http://www.lon2beach.gov/finance/fees and charges/ ➢ Annual Registration Fee: $ 100.00 ➢ Late Fee Total(if applicable) $ ➢ Total submitted $ ^ Payment Method: EF Cash Check No: Verification of Person Responsible for Report Preparation: Print Name: Alex Cherin Title: Owner Address: I have used all reasonable diligence in preparing this report. I have reviewed all the sections and to the best of my knowledge the information contained herein is true and complete. I certify under penalty of perjury under the laws of the State of California that the foregoing is true and correct. 1/15/2015 (. Date: Signature: �.:...:._� -. .,.~ City of Long Beach Lobbyist Renewal Report Form—10/2012 Page 1 of 1