Jonah Wolfson December 2012 Form 9 QUARTERLY GIFT DISCLOSURE
(GIFTS OVER $100)
LAST'NAME-FIRST NAME-MIDDLE NAME: NAME OF AGENCY:
WOLFSON, JONAH CITY OF MIAMI BEACH
MAILING ADDRESS: OFFICE OR POSITION HELD:
1700 CONVENTION CENTER DRIVE COMMISSIONER
CITY- ZIP.. COUNTY- FOR QUARTER ENDING(CHECK ON ): YEAR
MIAMI BEACH, FL 33139 DADS ❑MARCH ❑JUNE ❑SEPTEMBER DECEMBER 20ja,,
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 fads,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 •.
PART B—RECEIPT PROVIDED BY PERSON MAKING THE GIFT
C:,
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,-gf thceipt to this
form.You may attach an explanation of any differences between the information disclosed on this form and the informaTion on-Fe 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 FLORIri(��
COUNTY OF
depose on oath or affirmation and say that the information disclosed Sworn to or affirmed)and ub ri �d for me this
day of 120
herein and on ny a chments made by me constitutes a true accurate,
by
and total lis ng of all -fts required to be reported by ction 112.3148,
Florida St tes. (Signature of Nota Public-State o Florida)
(Print,Type,or Stamp missioned Name of Notary Public)
SIGNAT E OF R OP. G OFFICIAL Personally Known V OR Produced Identification
Type of Identification Produced
PART D—FILING INSTRUCTI
�.•`.� �s�% BARBARA PAREDES
This form,when duly signed and notarized,must be filed with the Commission on Ethics,P. _TWbj�qp%IkQgft"ffWlaa; ysi-
cal address:3600 Maclay Blvd.South,Suite 201,Tallahassee,Florida 32312.The form mu ar �r}• s � �f� 1ni� rter
that follows the calendar quarter for which this form is filed(For example,if a gift is received of i` ��� u 0 g$s�0 � i4l
10
CE FORM 9-EFF. 1/2007 s)
FORM 9 QUARTERLY GIFT DISCLOSURE
.(ATTACK MENT)
RE: Commissioner Jonah Wolfson
Ticket Distribution for October—December 2012
City of Miami Beach Mayor and Commission Office
DATE EVENT VALUE
11/29/12 Minority Chamber of Commerce Gala Awards
Provided by City of Miami Beach
1700 Convention Center Dr.
Miami Beach, FL 33139
1 tickets @ $250.00 ea $250.00
o
I
i