Ed Tobin - March 2014 Form 9 I
Form 9 QUARTERLY GIFT DISCLOSURE
(GIFTS OVER $100)
LAST NAME—FIRST NAME—MIDDLE NAME: NAME OF AGENCY:
MAILING ADDRESS: OFFICE OR POSITION HELD:
['10 0 �-r� 2 Co m 5S�a► �
CITY: ZIP: COUNTY: FOR QUARTER ENDING(CHECK ONE): YEAR
❑MARCH ❑JUNE ❑SEPTEMBER El DECEMBER 20
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
=� o
❑ CHECK HERE IF CONTINUED ON SEPARATE SHEET °—
G
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 RAWWO f c ON#
❑ CHECK HERE IF A RECEIPT IS ATTACHED TO THIS FORM
NLITARY PUBLIC
'° TATE OF FLORIDA
'
comm Expire EE041961
PART C—OATH '�s, ;g Expires 11/15/2014
I,the person whose name appears at the beginning of this form,do STATE OF FLORIDA
COUNTY OF
depose on oath or affirmation and say that the information disclosed Sworn to(or affirmed)and subscribed before me this
n-1 day of .jv64 _,20 1
herein and on any attachments made by me constitutes a true accurate, V ��
by
and total listing of all gifts required to be reported by Section 112.3148,
Florida Statutes. (Signature of Notary Public-State of Florida)
s
(Print,Type,or Stamp Commissioned Name of Notary Public)
SIGNATURE OF REPORTING OFFICIAL Personally Known 7� OR Produced Identification
Type of Identification PTroduced
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)
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DESIGN AND
L�M REMODELING ®W
~`�' ° ® ; Miami Beach Convention Center
=_ 1901 Convention Center Drive
_-� March 21-24, 2014
Fri.Mar,21 Sat. Mar.22 Sun. Mar.23 Mon.Mar.24
4:00 pm-10:30 pm Noon-10:30 pm Noon-7:30 pm 6:00 pm-10:30 pm
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Good for one admission, to be taken at door.
N_ 5 9 0 2 Not for resale. Nontransferable.
Home Show Mgmt.Corp.: Executive Office(305)667-9299
4300�00�8 SECTION
ROW SEAT
GENERAL ADMISSIO GEN ADM
New World School of the Arts ;EraERAL ADMIS:
Theatre Division
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Presents o,� GEN
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—� Into The Woods
Colony Theatre
February 28, 2014 7o30PM
Friday +30000028
No Refunds, No Returns, No Exchanges
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0 .00 RIGHT ORCH 0 .00 TAX 0.00
WILLIAM SHAKESPEARE'S
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BALLET ETUDES CO OF SO r LA Jrchestra Rio-,
;® IN THE FULL LENGTH BALLET
;- - SLEEPING BEAUTY �ow
_ COLONY THEATER :EA 2
SATURDAY MARCH 4 2014 8:OOPM
® No Refunds, No Returns, No Exchanges 430002307