Donald M. Papy September 2012e �
9
FORM QUARTERLY GIFT DISCLOSURE
(GIFTS OVER $100) I
LAST NAME—FIRST NAME-MIDDLE NAME: i NAME OF AGENCY:
PAPY, DONALD M. I CITY OF MIAMI BEACH
j MAILING ADDRESS: I OFFICE OR POSITION HELD:
1700 CONVENTION CENTER DRIVE, 4TH FL j CHIEF DEPUTY CITY ATTORNEY
CITY ZIP: COUNTY: FOR QUARTER ENDING(Che k One):
YEAR I
1►ff�Ail BEACH, FL 33139 DADE + MARCH JUNE �EPTEMBER DECEMBER 20 �
i
PART A - STATEMENT OF GIFTS
Please list below each gift, the value of which you believe to exceed $100, accepted by you during the calendar quarter for which this
statement is being filed. You are required to describe the gift and state the monetary value of the gift, the name and address of the person
I making the gift, and the date(s) the gift was received. If any of these facts, other than the gift description, are unknown or not applicable,
you should so state on the form. As explained more fully in the instructions on the reverse side of the form, you are not required to disclose
I gifts from relatives or certain other gifts. You are not required to file this statement for any calendar quarter during which you did
not receive a reportable gift.
DATE I DESCRIPTION MONETARY NAME OF PERSON ADDRESS OF PERSON
RECEIVED OF GIFT I VALUE I MAKING THE GIFT MAKING THE GIFT
I
PLEASE SEE ATTACHED
{� N
3
CHECK HERE IF CONTINUED ON SEPARATE SHEET 3
PART B - RECEIPT PROVIDED BY PERSON MAKING THE GIFT
If any receipt for a gift listed above was provided to you by the person making the gift,you are required to attach a copy of that receipt to this form.You may
attach an explanation of any differences between the information disclosed on this form and the information on the receipt.
CHECK HERE IF A RECEIPT IS ATTACHED TO THIS FORM
PART C - OATH
1, the person whose name appears at the beginning of this form, STATE OF FLORIDA
do depose on oath or affirmation and say that the information COUNTY OF MIAMI—DADS
Sworn to(or affirmffnand subscribed before me this
disclosed herein and on any attachments made by me consti-
I day of 20 fZ
tutes a true, accurate, and total listing of all gifts required to be
b DONA� M. P Y
reported by Section 112.3148, Florida Statutes. y
(Signatur f IkL/i_C,t,.o
,,••; Y:"'.•-, YAWLEX MORALES
= Commission#DD 870863
:t. .�_
:a Expires March 16,2013
SIGNA REPORTI •;.,,,
ICI (Print.Type,o. St p
7019
Personally Known OR Produced Identification
i
Type of Identification Produced
PART D - FILING INSTRUCTIONS
j This form, when duly signed and notarized, must be filed with the Commission on Ethics, P.O. Drawer 15709, Tallahassee, Florida
32317-5709. The form must be filed no later than the last day of the calendar quarter that follows the calendar quarter for which this form is
filed. (For example, if a gift is received in March, it should be disclosed by June 30.)
CE FORM 9-EFF. 1/2001 (See reverse side for instructions)
Over a$100
Date Description Monetary Name of person Address of person
Rec. of gift Value making the gift making the gift
City of Miami Beach 1700 Convention Center Dr.
Miami Beach,FL 33139
06/19/12 Funkshion 2012 VIP $200.00 cc "
09/14/12 Chris Isaak $139.00 " "
09/15/12 11th Annual Miami
Int'I Wine Fair $250.00 96 it
09/15/12 XVlllnternational
Ballet $130.00 "
09/16/12 II Volo $159.00 "
09/18/12 Jethro Tull's
Ian Anderson $115.00 "
09/19/12 II Volo $159.00 99