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2015-rCordero&Assc Date Stamp City of Long Beach LOBBYIST RENEWAL FORM i . i �' own ad Form INSTRUCTIONS 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 75 for: Lobbyist Name: Gloria Cordero Filer ID Number: 13-022 ------------------------------------------------------------------- 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($100.00).The applicable fee is due at the time of registration renewal. Payment will be deemed delinquent thereafter.Late Fees will be assessed on a per day basis in accordance with Long Beach Municipal Code 2.80,and the most recent Fee Schedule approved by Long Beach City Council. lrttp://lviviv.lon beach. ov/rh!Ance/fees and ckrar°$es/ ➢ Annual Registration Fee: $ 100.00 ➢ Late Fee Total(if applicable) $ ➢ Total submitted $ 100.00 Payment Method: El Cash El Check No: 11519 Verification of Person Responsible for Report Preparation: Print Name: Gloria Cordero Title: Principal 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. Date: Signature: City of Long Beach Lobbyist Renewal Report Form—10/2012 Page 1 of 1