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Elizabeth Wheaton Form 9 Gift Disclosure March 2017Form 9 QUARTERLY GIFT DISCLOSURE (GIFTS OVER $100) LAST NAME -- FIRST NAME -- MIDDLE NAME: NAME OF AGENCY: Wheaton Elizabeth Sarah City of Miami Beach MAILING ADDRESS: OFFICE OR POSITION HELD: 1700 Convention Center Drive Chief of Staff to the Mayor & City Commission CITY: ZIP: COUNTY: WR QUARTI❑R ENDING (CHECK ONE): YEAR Miami Beach 33139 Miami -Dade ARCH JUNE SEPTEMBER ❑ DECEMBER 2017 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 RECEIVED DESCRIPTION OF GIFT MONETARY VALUE NAME OF PERSON MAKING THE GIFT ADDRESS OF PERSON MAKING THE GIFT 3/12/17 Travel expenses to SWSW Conference to speak. $1,508 Nordic Council Stensberggata 25 NO -0170 Oslo, Norway ❑ CHECK HERE IF CONTINUED ON SEPARATE SHEET 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. 2( 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 FLORIDA COUNTY OF !'A Chan I '"j)P1'Z)6 depose on oath or affirmation and say that the information disclosed Sworn toC(or affirmed) and subs ibed before me this day of 1�iV herein and on any attachments made by me constitutes a true accurate, by ik)HC4TalN1 and total listing of all gifts required to be reported by Section 112.3148, ZFIra S tutes. GNA REPORTING OFFICIAL of Notary Public -State of (Print, Type, or Stamp C mmissioned Name of Notary Personally Known V OR Produced Identificatio Type of Identification Produced PART D — FILING INSTRUCTIONS A0 A � . e This form, when duly signed and notarized, must be filed with the Commission on Ethics, P.O. Drawer 15709, Tallahassee, Florida 31P7-5769; p cal address: 325 John Knox Road, Building E, Suite 200, Tallahassee, Florida 32303. The form must be filed no later than the last d 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 (Refer to Rule 34-7.010(1)(g), F.A.C.)(Rev. 9/2014) (See reverse side for instructions) Nordic Innovation Template for travel expenses (external) For your information • Original receipts of payment must be attached (please make a copy for your own account). • For reimbursement for more than one person, please list the names below: Travel expenses for SXSW — EU Pavilion — Nordic Climate Innovation event: Session Personal Information Recipient name Elizabeth Wheaton Address 1700 Convention Center Drive Zip code 33139 City and country Miami Beach, Florida, U.S.A E-mail elizabethwheaton(a)miamibeachfl.gov Bank account Bank account holder Elizabeth Wheaton International Bank Account Number (IBAN) (ROUTING #) Swift (BIC) (ACCT #) Cost for reimbursement Nordic Innovation will reimburse travel costs up to i.5oo USD. Travel expenses Type of cost (travel by flight, train, bus, boat, taxi, and/or accommodation) Amount (In the currency used on the receipt) Lodging $849.85 Airfare (Miami to Austin to Miami) $658.40 Total 3.,5o8.25 Stensberggata 251 NO -0170 Oslo I Norge — Norway I Telefon (+47) 47 6144 00 1 Org.nr.: NO 9725'6577 info@nordicinnovation.org I www.nordicinnovation.org 4) DOUBLETREE aY NILTON DOUBLETREE SUITES BY HILTON AUSTIN 303 WEST 15TH AUSTIN, TX 78701 United States of America TELEPHONE 512-478-7000 • FAX 512-478-3562 Reservations www.doubletree.com or 1 -800 -222 -TREE WHEATON, ELIZABETH Room No: 1514/NK1KB CHARGES Arrival Date: 3/12/2017 1:43:00 PM JINSUIMANSION10E-H Departure Date: 3/13/2017 12:03:00 PM 3916506 Adult/Child: 2/0 200120 Cashier ID: DHARDE UNITED STATES OF AMERICA Room Rate: 739.00 AX *6006 AL: HH # $0.00 VAT # Folio No/Che 722696 A Confirmation Number: 82274686 DOUBLETREE SUITES BY HILTON AUSTIN 3/17/2017 10:35:00 AM DATE REF NO DESCRIPTION CHARGES 3/12/2017 3916506 GUEST ROOM $739.00 3/12/2017 3916506 STATE TAX $44.34 3/12/2017 3916506 CITY TAX $66.51 3/13/2017 3916849 AX *6006 ($849.85) "BALANCE" $0.00 Page:1 Refund I Receipt Page 1 of I Search aa.com p American Airlines ; G� Refunds - Start Over Help WHEATON, ELIZABETH Thank you for choosing American Airlines, a member of the oneworlde Alliance. We are happy to provide a copy of your ticket receipt. Itinerary Information Origin City Destination City Airline Flight Booking Flight Date Flight Status Fare Base Number Class Time MIA AUS AA 4595 M 03/12/2017 09:30 USED M3AJZNNI AUS MIA AA 4597 M 03/13/2017 05:00 USED M3AJZNNI Receipt Passenger Tlcket # Fare Taxes and Carrier Ticket Total WHEATON, ELIZABETH 0012117939098 586.04 USD 63.36 USD 658.40 USD Sale Form of Payment Credit Card Type Number Credit Card MASTER CARD xpc00000000c5375 Print https://prefunds.aa.com/refunds/requestedReceipt 3/23/2017