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Qualifying documents Tobin RECFIVFO CANDIDATE OATH - 201 +7 NONPARTISAN OFFICE AN h I' 1 3 CITY CLE \I- OFF (Not for use by Judicial or School Board Candidates) OFFICE USE ONLY OATH OF CANDIDATE (Section 99.021, Florida Statutes) ‘•••""'" (PLEASE PRINT NAME AS YOU WISH IT TO APPEAR ON THE BALLOT * - NAME MAY NOT BE CHANGED AFTER THE END OF QUALIFYING) am a candidate for the nonpartisan office of c L�� , N/A (office) (district #) N/A .6:071 am a qualified elector of � County, Florida, (circuit #) (group or seat #) I am a qualified elector of the City of Miami Beach, Florida, r within the City at least one year before qualifying for City of Miami Beach elected office, with my legal residence being:. , . . , Miami Beach, Florida. I am qualified under the ordinances and Charter of said City and under the Constitution and the Laws o lorida to hold the office to which I desire to be nominated or elected; I have qualified for no other public office in the state, the term of which office or any part thereof runs concurrent with the office I seek; and I have resigned from any office from which I am required to resign pursuant to Section 99.012, Florida Statutes; and I will support the Constitution of the United States and the Constitution of the State of Florida. # tf 5:2 / V- - ..›,7 4 5 - 15 - phone umber maii Address Signature of andidate t X 9 p • �' 1 a/► Address � '� r� City ate ZIP ode Candidate's Florida Voter Registration Number (located on your voter information card): f ©' Z2 s ,` * Please print name phonetically on the line below as you wish it to be pronounced on the audio ballot for persons with disabilities (see instructions on page 2 of this form): 67X2 STATE OF FLORIDA COUNTY OF M 4 fr 1 - DA)) 6" • Sworn to or affirmed) and ( ) subscribed before me this 42 day of SC f ren'I , 20 If NOTARY PUiifl, - 6TATE OF FLORIDA f r ikz� zrt E. Farther Personally Known: or CommiKicn # DD896080 - Expi: e,: JUNE 03, 2013 Signature of Notary Public Produced Identification: BONDED T rr ,A ,ti t)C r' "'':' `,�;c °. INC Print, Type, or Stamp Commissioned Name of Notary Public Type of Identification Produced: DS -DE 25 (Rev. 5111) Rule 1S- 2.0001, F.A.C. FORM 1 STATEMENT OF 2010 Please print or type your name, mailing FINANCIAL INTERESTS address, agency name, and position below: LAST NAME -- FIRST NAME -- MI LE NAME : � / ' # 715 FOR OFFIC F ` "' T I 1 6/ii. "des: USE ONLY: ,R MAILING ADDRE S : 2011 SEP .. 7 AM M 11 + : ' 4TOD , (1,-7..i/ 4- p•Ati, 4 02 . ‘-',,e...4 i ,,..; .... Cl : ZIP . COUNTY ID No. NAME OF AGENCY : Conf. Code dim Av�� 6/y ' /. J SSA N AM E OF OFFIC POSITION HEELb UGHT : P Req. Code You are not limited to the space on the lines on this form. Attach additional sheets, if necessary. CHECK ONLY IF A CANDIDATE OR ❑ NEW EMPLOYEE OR APPOINTEE * *BOTH PARTS OF THIS SECTION MUST BE COMPLETED ** DISCLOSURE PERIOD: THIS STATEMENT REFLECTS YOUR FINANCIAL INTERESTS FOR THE PRECEDING TAX YEAR, WHETHER BASED ON A CALENDAR YEAR OR ON A FISCAL YEAR. PLEASE STATE BELOW WHETHER THIS STATEMENT IS FOR THE PRECEDING TAX YEAR ENDING EITHER (must check one): RI DECEMBER 31, 2010 OR 0 SPECIFY TAX YEAR IF OTHER THAN THE CALENDAR YEAR: MANNER OF CALCULATING REPORTABLE INTERESTS: THE LEGISLATURE ALLOWS FILERS THE OPTION OF USING REPORTING THRESHOLDS THAT ARE ABSOLUTE DOLLAR VALUES, WHICH REQUIRES FEWER CALCULATIONS, OR USING COMPARATIVE THRESHOLDS, WHICH ARE USUALLY BASED ON PERCENTAGE VALUES (see 4 instructions for further details). PLEASE STATE BELOW WHETHER THIS STATEMENT REFLECTS EITHER (must check one): 0 COMPARATIVE (PERCENTAGE) THRESHOLDS OR ❑ DOLLAR VALUE THRESHOLDS ' PART A -- PRIMARY SOURCES OF INCOME [Major sources of income to the reporting person] (If you have nothing to report, you must write "none" or "n /a ") NAME OF SOURCE SOURCE'S DESCRIPTION OF THE SOURCE'S _ i a INCOME ADDRESS PRINCIP• BU INESSACTIVITY AXIAPAIIMMIFAMP .- Ae ii PART B -- SECONDARY SOURCES OF INCOME [Major customers, clients, and other sources of income to businesses owned by the reporting person] (If you have nothing to report , you must write "none" or "n /a ") NAME OF NAME OF MAJOR SOURCES ADDRESS PRINCIPAL BUSINESS BUSINESS ENTITY OF BUSINESS' INCOME OF SOURCE ACTIVITY OF SOURCE • in PART C -- REAL PROPERTY [Land, buildings owned by the reporting person] (If you have nothing to report, you must write "none" or "n /a ") FILING INSTRUCTIONS for when and where to file this form �� ,r• ' �'� are located at the bottom of page 2. ii A 00 ‘. INSTRUCTIONS on who must file this form and how to fill it out begin on page 3. OTHER FORMS you may need to file are described on page 6. / CE FORM 1 - Effective: January 1, 2011. Refer to Rule 34- 8.202(1), FA.C. (Continued on reverse side) PAGE 1 r PART D — INTANGIBLE PERSONAL PROPERTY [Stocks, bonds, certificates of deposit, etc.] (If you have nothing to report, you must write "none" or "n /a") TYPE OF INTANGIBLE _ BUSINESS ENTI TO WHICH THE PROPERTY RELATES ` Z2 ��= '2 r0 it A PART E — LIABILITIES [Major debts] (If you have nothing to report, you must write "none" or "n /a ") NAME OF CREDITOR ADDRESS OF CREDITOR / aj _ f r- PART F — INTERESTS IN SPECIFIED BUSINESSES [Ownership or positions in certain types of businesses] (If you have nothing to report, you must write "none" or "n /a ") BUSIN S ENTITY # 1 BUSINESS ENTITY # 2 BUSINESS ENTITY # 3 NAME OF BUSINESS ENTITY ' c z i r i , �/A e ADDRESS OF BUSINESS ENTITY /25* ) PRINCIPAL BUSINESS ACTIVITY b"" 4' + C..� POSITION HELD WITH ENTITY C j. a r I OWN MORE THAN A 5% INTEREST IN THE BUSINESS LJ!. NATURE OF MY OWNERSHIP INTEREST IF ANY OF PARTS A THROUGH F ARE CONTINUED ON A S PARATE SHEET, PLEASE CHECK HERE ❑ SIGNATURE (required): / ZIII4 DATE SIGNED (required): FILIN ` CTIONS: WHAT TO FILE: WHERE TO FILE: WHEN TO FILE: After completing all parts of this form, including If you were mailed the form by the Commission initially, each local officer /employee, state signing and dating it, send back only the first on Ethics or a County Supervisor of Elections for officer, and specified state employee must sheet (pages 1 and 2) for filing. your annual disclosure filing, return the form to file within 30 days of the date of his or her that location. appointment or of the beginning of employ - If you have nothing to report in a particular ment. Appointees who must be confirmed by section, you must write "none" or "n/a" in that Loca /officers /emplo file with the Supervisor of Elections of the county in which they perms- the Senate must file prior to confirmation, even section(s). nently reside. (If you do not permanently reside if that is less than 30 days from the date of their in Florida, file with the Supervisor of the county appointment. Facsimiles will not be accepted. where your agency has its headquarters.) Candidates for publicly - elected local office NOTE: State officers or specified state employees must file at the same time they file their MULTIPLE FILING UNNECESSARY: file with the Commission on Ethics, P.O. Drawer qualifying papers. Generally, a person who has filed Form 1 for a 15709, Tallahassee, FL 32317 -5709; physical Thereafter, local officers /employees, state calendar or fiscal year is not required to file a address: 3600 Maclay Boulevard, South, Suite officers, and specified state employees are second Form 1 for the same year. However, a 201, Tallahassee, FL 32312. required to file by July 1st following each candidate who previously filed Form 1 because Candidates file this form together with their calendar year in which they hold their posi- of another public position must at least file a copy qualifying papers. tions. of his or her original Form 1 when qualifying. Finally, at the end of office or employment, To determine what category your position falls under, see the "Who Must File" Instructions each local officer /employee, state officer, and on page 3. specified state employee is required to file a final disclosure form (Form 1 F) within 60 days of leaving office or employment. CE FORM 1 - Effective: January 1, 2011. Refer to Rule 34 -8.202 (1), F.A.0 PAGE 2 — - ---- - - -' ,. 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 OMARCH %JUNE OSEPTEMBER 0 DECEMBER 20 11 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 &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 e-4 0 CHECK HERE IF CONTINUED ON SEPARATE SHEET (--) -- -- ...< 3 ' 1 ' 7 PART B — RECEIPT PROVIDED BY PERSON MAKING THE GIFT 1 ,.._ c.) ,..-..., - .7- ; If , kg) M any receipt for a gift listed above was provided to you by the person making the gift, you are required to attach a copy to-"othat receipt to4Ais form. You may attach an explanation of any differences between the information disclosed on this form and the informatioalm theicpcei< MC C:i 11 0 CHECK HERE IF A RECEIPT IS ATTACHED TO THIS FORM --r1 14,,.? --, ---,.., • ....} PART C — OATH r - , I, the person whose name appears at the beginning of this forrn, do STATE OF FLORI,D, coursa OF niOrrtr depose on oath or affirmation and say that the information disclosed Swam to (or affirmed) and subscnbed before me this c73 day of /..\33, i , 20 (1 heren m i and on any attachments made by me constitutes a true accurate, • by P--C4 1 c)b and total listing of all gifts required to be reported by Section 112.3148, Aeh, ?„,,,f, " ---- - )h Florida Statutes (Signature of Notary Pu lic-State FkidaJ (Print, Typ. SIGNATURE 0 - - *MING • - IAL I Persona ,. "' '`!:' . '" r -4 * _ Type of Id, , oi.1 -7 ' 11A I I 1 t 600601001 s OD nall PART D — FILING INSTR , :: ' agparammOdiamillieler This form, when duly signed and notarized, must be filed with the Commission on Ethic-s, RO. Drawer 15709, Tallahassee, Fonda 32317-5709; physi- cal address: 3600 Maclay Blvd. South, Suite 201, Tallahassee, Florida 32312. 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. 1/2007 (See reverse side for instructions) Qr FORM 9 QUARTERLY GIFT DISCLOSURE (ATTACHMENT) RE: Commissioner Ed Tobin Ticket Distribution for April — June 2011 City of Miami Beach Mayor and Commission Office DATE EVENT VALUE Apr. 14 Beach Boys Provided by City of Miami Beach 1700 Convention Center Dr. Miami Beach, FL 33139 2 tickets @ $145.00 ea. $296.00 Apr. 16 Bill Frisell Provided by City of Miami Beach 1700 Convention Center Dr. Miami Beach, FL 33139 2 tickets @ $50.00 ea. $100.00 May 7 Amaury Gutierrez Provided by City of Miami Beach 1700 Convention Center Dr. Miami Beach, FL 33139 2 tickets @ $73.00 ea. $146.00 May 14 C.0 M.B. (La Faille Mal Gardee) Provided by City of Miami Beach Miami Beach, FL 33139 4 ticket ® $66.50 ea. $266.00 June 04 Guest ticket for the Miami Beach Chamber Gala Provided by City of Miami Beach 1700 Convention Center Dr. Miami Beach, FL 33139 1 tickets @ $250.00ea. $250.00 June 11 Diego Torres Provided by City of Miami Beach 1700 Convention Center Dr. Miami Beach, FL 33139 2 tickets @ $56.50 ea. $113,00 EDWARD TOBIN CAMPAIGN ACCOUNT Wachovla Bank, 1002 1800 SUNSET HARBOR DRIVE STE 2 a division of Wells Fargo Bank, N.A. MIAMI BEACH, FL 33139 63= 643/670 9/6/2011 • PAY TO THE City of Miami Beach * *1,020.00 N ORDER OF `° One Thousand Twenty a nd 001100 ************** * * * * * * * * * * * * * *,* * * * * * * * * * * * * * ** DOLLARS in City of Miami Beach LL MEMO Reelection Nr AUTHORIZED SI NATURE u'