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Max Sklar March 2014 Form 9 Form 9 QUARTERLY GIFT DISCLOSURE 0A (GIFTS OVER $100) LAST NAME--FIRST NAME--MIDDLE NAME: NAME OF AGENCY: SK!ar ax 0sTv of/ inm i � > MAILING ADDRESS: o OFFICE OR POSITION HELD: IrIDD Coovtaw n Cer &r .Dre V1& d nd �()DM W*_ INYODPMent efDr CITY: ZIP: COUNTY: FOR QUARTER ENDING(CHECK ONE): YEAR Miami t .3.313q rniam.',Dads AfIARCH ❑JUNE ❑SEPTEMBER ❑DECEMBER 20L 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 Awr, 'gym.B 6 DA 300 qjsTjEMft o P PAChW --whch 0585.1 ART &,56L m,am j btl ach FL �IThided ode 1� 33140 el�cKetG 2 @r Ike,0)Usilp Miam I � rne t arch Pd ark Co I)nti flad t Kt e a 5 per da ❑ CHECK HERE IF CONTINUED ON SEPARATE SHEET �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 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 NL. LINETTE NODA SE « of Florida PART C—OATH •_ My Comm.Expires Sep 4,2015 ''�� «�' Commission#EE 93565 I,the person whose name appears at the beginning of this form,do STATE OF FLORID �► �� onded Through National Notary Assn. COUNTY OFL<<a'VI 1 depose on oath or affirmation and say that the information disclosed Sworn to(or affirmed)and subscribed before me this 9 day of 20 herein and on any attachments made by me constitutes a true accurate, by f Cs✓✓ r and total listing of all gifts required to be reported by Section 112.3148, AO/N Florida 7,tes. (Signature of tary Pub c-State of Florida) (Print,Type,or Stamp Commissioned Name of Notary Public) SIG OF R TING OFFICIAL Personally Known ( rR Produced Identification Type of Identification Produced GelG PART D—FILING INSTRUCTIONS This form,when duly signed and notarized,must be filed with the Commission on Ethics,P.O.Drawer 15709,Tallahassee,Florida 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)121-