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Matti Bower September 2012 Fora, 9 QUARTERLY GIFT DISCLOSURE (GIFTS OVER $100) LAST NAME—FIRST NAME—MIDDLE NAME: NAME OF AGENCY: -R()WFR MATIT CITY OF M1 A MT RE A CH MAILING ADDRESS: OFFICE OR POSITION HELD: YOR CITY: ZIP: COUNTY: FOR QUARTER ENDING (CHECK ONE): YEAR ❑MARCH ❑JUNE SEPTEMBER C3 DECEMBER 20� MIAMI BEACH FL 33139 DARE ` 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 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 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 DESCRIPTION MONETARY NAME OF PERSON ADDRESS OF PERSON RECEIVED OF GIFT VALUE MAKING THE GIFT MAKING THE GIFT SEE ATTAC ED N _ C:7 `y r-J ❑ CHECK HERE IF CONTINUED ON SEPARATE SHEET ,. rD '•�tl PART B—RECEIPT PROVIDED BY PERSON MAKING THE GIFT -;' r o 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 ttr81 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 I,the person whose name appears at the beginning of this form,do STATE OF FLOR A COUNTY OF depose on oath or affirmation and say that the information disclosed Sworn to(or a rmed)and ubscribed before me this 070 day of EC-_ f R ,20 /a herein and on any attachments made by me constitutes a true accurate, by au Tr� E and total listing of all gifts required to be reported by Section 112.3148, �7 • Florida Statutes. (Signature o- otary-Public (Print,Type,or Stamp mmissioned Name of Notary Public) SIG U P ING AL Personally Known OR Produced Identification Type of Identification Produced PART D—FILING INSTRUCTIONS .� va��a ALEJANDRO J.FERNANDEZ ary FuDlic-State of or This form,when duly signed and notarized,must be filed with the Commission on Ethics,P.O.Drawer 1 ��eAI ycGWgM? &�1�18y291 cal address:3600 Maclay Blvd.South,Suite 201,Tallahassee,Florida 32312.The form must be filed no t ast dftMWaWe#cWjM27 that follows the calendar quarter for which this form is filed(For example,if a gift is received in March,it hou P isclos d bv June 30. CE FORM 9-EFF.1/2007 ^ (See reverse side for instructions)� FORM 9 Q UARTERLY GIFT DISCLOSURE (ATTACHMENT) RE: Mayor Matti Bower Ticket Distribution for July—September 2012 City of Miami Beach Mayor and Commission Office DATE EVENT VALUE 7/19/12 Swim Fashion Week Provided by City of Miami Beach 1700 Convention Center Dr. Miami Beach, FL 33139 2 tickets @ $100.00 ea. $200.00 7/21/12 Made in Fashion Provided by City of Miami Beach 1700 Convention Center Dr. Miami Beach, FL 33139 2 tickets @ $75.00 ea. $150.00 7/28/12 Gian Marco Provided by City of Miami Beach 1700 Convention Center Dr. Miami Beach, FL 33139 2 tickets @ $88.50 ea. $177.00 8/04/12 Arango y Sanint Provided by City of Miami Beach 1700 Convention Center Dr. Miami Beach, FL 33139 2 tickets @ $53.50 ea. $107.00 8/31-9/4-/12 Miami International Home Show Provided by City of Miami Beach 1700 Convention Center Dr. Miami Beach, FL 33139 10 tickets @ $10.00 ea. $100.00 9/12/12 IL Volo Provided by City of Miami Beach 1700 Convention Center Dr. Miami Beach, FL 33139 2 tickets @ $79.50 ea. $159.00 9/14/12 Chris Isaak Provided by City of Miami Beach 1700 Convention Center Dr. Miami Beach, FL 33139 2 tickets @ $69.50 ea. $139.00 FORM 9 QUARTERLY GIFT DISCLOSURE (ATTACHMENT) RE: Mayor Matti Bower Ticket Distribution for July—September 2012 City of Miami Beach Mayor and Commission Office DATE EVENT VALUE 9/16/12 IL Volo Provided by City of Miami Beach 1700 Convention Center Dr. Miami Beach, FL 33139 2 tickets @ $79.50 ea. $159.00 9/15/12 XVII International Ballet Festival Provided by City of Miami Beach 1700 Convention Center Dr. Miami Beach, FL 33139 2 tickets @ $65.00 ea. $130.00 9/15/12 XVII International Ballet Festival Gala Provided by City of Miami Beach 1700 Convention Center Dr. Miami Beach, FL 33139 1 tickets @ $125.00 ea. $125.00 9/15/12 11th Annual Miami Int'l Wine Fair Provided by City of Miami Beach 1700 Convention Center Dr. Miami Beach, FL 33139 2 tickets @ $125.00 ea. $250.00 9/18/12 Jethro Tull/Ian Anderson Provided by City of Miami Beach 1700 Convention Center Dr. Miami Beach, FL 33139 2 tickets @ $57.50 ea. $115.00 9/19/12 IL Volo. Provided by City of Miami Beach 1700 Convention Center Dr. Miami Beach, FL 33139 2 tickets @ $79.50 ea. $159.00