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Ed Tobin December 2012 Form 9 QUARTERLY GIFT DISCLOSURE (GIFTS OVER $100) LAST NAME-FIRST NAME-MIDDLE NAME: NAME OF AGENCY: TOBIN, ED CITY OF MIAMI BEACH MAILING ADDRESS: OFFICE OR POSITION HELD: 1700 CONVENTION CENTER DRIVE COMMISSIONER CITY: ZIP: COUNTY: FOR QUARTER ENDING(CHECK ONE): YEAR MIAMI BEACH, FL 33139 DADE ❑MARCH (DJUNE OSEPTEMBER DECEMBER 20-1 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 ATTACHED ❑ CHECK HERE IF CONTINUED ON SEPARATE SHEET E `f s 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-#drat ript to this form.You may attach an explanation of any differences between the information disclosed on this form and the informatiomoon 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 FLORID IV 1 COUNTY OF V depose on oath or affirmation and say that the information disclosed Sworn tojW affirmed)and ub,cr' edt e r me this day of Z 20 IS herein and on any attachments made by me constitutes a true accurate, by ipon and total listing of all gifts required to be reported by Section 112.3148, Florida Statutes. (Signature of No Public-State of Florida) (Print,Type,or Stamp C missioned Name of Notary Public) SIGNATURE OF REPORTING OFFICIAL Personally Known V OR Produced Identification Type of Identification Produced PART D—FILING INSTRU 10�11 BARBARA PAREDE This form,when duly signed and notarized,must be filed with the Commission on Ethics, Q' r 5 4�a�i����e,910:19�d�-ft 9;physi- cal address:3600 Maclay Blvd.South,Suite 201,Tallahassee,Florida 32312.The form `la �fh�IW(ftya4t'h@,206 r quarter that follows the calendar quarter for which this form is filed(For example,if a gift is rece d irY �b 'pit shout)@ME4j P�lOsocEeyg�t M40.) CE FORM 9-EFF. 1/200,7 (See reverse side or s ctions)':,51' a FORM 9 QUARTERLY GIFT DISCLOSURE (ATTACHMENT) RE: Commissioner Ed Tobin Ticket Distribution for October—December 2012 City of Miami Beach Mayor and Commission Office DATE EVENT VALUE 10/6/12 Sparkle 16th Annual National Gay& Lesbian Task Force Dinner Provided by City of Miami Beach 1700 Convention Center Dr. Miami Beach, FL 33139 1 tickets @ $200.00 ea $200.00 10/11/2012 Australian Pink Floyd Provided by City of Miami Beach 1700 Convention Center Dr. Miami Beach, FL 33139 2 tickets @ $50.50 ea. $101.00 10/12/2012 Olga Tanon Provided by City of Miami Beach 1700 Convention Center Dr. Miami Beach, FL 33139 2 tickets @ $118.50 ea. $237.00 10/20/2012 Miami City Ballet Program 1 Provided by City,of Miami Beach 1700 Convention Center Dr. Miami Beach, FL 33139 2 tickets @ $85.00 ea. $170.00 _ 12/05/2012. The MMG Tour.Starring Provided by City of Miami Beach 1700 Convention Center Dr. Miami Beach, FL 33139 2 tickets @ $82.50 ea. $165.00 12/09/2012 Vladimir Issaev The Nutcracker y Provided by City of Miami Beach 1700 Convention Center Dr. Miami Beach, FL 33139 2 tickets @ $53.50 ea. $107.00 12/28/2012 Life in Color Day Glow Provided by City of Miami Beach 1700 Convention Center Dr. Miami Beach, FL 33139 2 tickets @ $60.00 ea. $120.00