Paid Lobbyist Withdrawal Form — Shawn Wilson, Lobbyist Registration (2011)

PALM BEACH COUNTY FLORIDA RECEIVED MAY -9 2011 PALM BEACH COUNTY Board of County Commissioners Paid Lobbyist WITHDRAW Form Fill out information requested and return original completed form to the address below. It is the duty of each lobbyist to continually update and file this information. Name of Lobbyist: Clifford Hertz Business Phone: [illegible] Firm Name (if applicable) Broad and Cassel Business Address (Street/P.O. Box, City, Zip Code) 1 North Clematis Street Suite 500, West Palm Beach, Florida 33401 Description of nature and extent of any direct business association or partnership with any current Palm Beach County Commissioner, Advisory Board member or County employee: Wife - Paula Ryan - Planning Commission; Commission on Affordable Housing Principal to Withdraw Principal Name: Shawn Wilson Firm Name: Housing Trust Group, LLC Address: 750 Malibu Bay Drive, West Palm Beach, FL 33401 Legislative Interest of Principal: Land Use and Zoning In compliance with Palm Beach County Lobbyist Registration Ordinance, Palm Beach County Code, Chapter 2, Article VIII, as amended, I hereby submit this withdraw form, and state that the information contained herein is true and correct. Registrant/Lobbyist is no longer representing the above principal x 5/3/11 Registrant/Lobbyist Signature Date Return original completed form to: Todd Bonlarron, Legislative Affairs Director 301 N. Olive Avenue, Suite 1101 West Palm Beach, FL 33401 (561) 355-3451