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Micky Steinberg Form 9!�: ^: I ;�� ^�: �� ! B � A C H OFFICE OF THE CITY CLERK City of Miami Beach, 1700 Convention Center Drive, Miami Beach, FL 33139 www.miamibeachfl.aov Telephone: 305.673-741 1 September 29, 2017 Florida Commission on Ethics P.O. Drawer 15709 Tallahassee, FL 32317-5709 Pursuant to Sec. 112.3148, Florida Statutes, please find Quarterly Gift Disclosure State Form (9), for the quarter ending June 2017, for the following City of Miami Beach Personnel: • Kristen Rosen Gonzalez — Commissioner, City of Miami Beach � Michael Grieco — Commissioner, City of Miami Beach • Micky Steinberg — Commissioner, City of Miami Beach • Rafael Granado — City Clerk, City of Miami Beach • Philip Levine — Mayor, City of Miami Beach Should you have any questions or require any additional information, please contact me at 305.673.7411. Respectfully, Rafael E. Granado, City Clerk Attachment REG:cd Sent Certified Return Receipt Form 9 QUARTERLY GIFT DISCLOSURE (GIFTS OVER $100) LAST NAME -- FIRST NAME -- MIDDLE NAME: NAME OF AGEI�t�Y: �7}�:n,ht;rq M�ck rU�-�� �� i"�i�,� `t���r-�c��'1 MAILING ADDRES'�: � OFFICE,�f� POSITION HELD: ,� i?U(� LC�V� v c��}� us^ l. �/!`izsr �Y � J�.- �1,, ;:� PY��. S S i c� �?c.=i C ITY: ��4��; !"�� Cd�.V� ZIP: COUNTY: FOR QUARTER ENDING (CHECK ONE): r--� ❑MARCH �:IUNE ❑SEPTEMBER ❑ DECEMBER � 3) �Ci ��(;w'�a — �c'�i�� PART A— STATEMENT OF GIFTS YEAR 20 � 7 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 tne 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 0 5 ��3 �/7 06 �03 /�� DESCRIPTION OF GIFT MDc.�.�. �,al-q. Nt�o�: 8ca.c� c.hcv�b�r- Cr-adw.. MONETARY VALU E � t5o .� 3Z5 NAME OF PERSON MAKING THE GIFT CMj3 CMB ADDRESS OF PERSON MAKING THE GIFT �?po �o,�N1M �Ah/" ow�c, 110o c.bwretMti co�a� Dn1�G � �� � ❑ CHECK HERE IF CONTINUED ON SEPARATE SHEET (:�F=–a "'r' F��r? "'°a � � ; i '�t7 �i PART B— RECEIPT PROVIDED BY PERSON MAKING THE GIFT `M;�= � � � � �;::� - 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:�zz�that I,�eipt't�his form. You may attach an explanation of any differences between the information disclosed on this form and the informatfe�bn tn'�rec�9j9Tt �'�"' fV r-- c� � ❑ CHECK HERE IF A RECEIPT IS ATTACHED TO THIS FORM r'�" � �n PART C — OATH I, the person whose name appears at the beginning of this form, do STATE OF FLORI � COUNTY OF � 1 /3�1 —1J /�0 E. depose on oath or affirmation and say that the information disclosed Sworn tQ (pr affirmed) and subscribed before me this L. `l day of ��(�T E�� �a t, '(Z , 20 �� herein and on any attachments made by me constitutes a true accurate, by T � t (v c���R,� �iAY� and total listing of all gifts required to be reported by Section 112.3148, ,. ••. ,,,�, . �� T� : Florida Statutes. v (Signature of Notary Public-State of Florida) ,�, �; ' '�, * ,,., , `� �' � (Print, Type, or Stamp Co missioned Name of Notary Public) � 3 z SIGNAT�RE bF REPORTING OFFICIAL Personally Known � OR Produced Identification � 3 3� D Type of Identification Produced , �� .,, v� �� g m PART D — FILING INSTRUCTIONS � � � > ��� �J�.> This form, when duly signed and notarized, must be filed with the Commission on Ethics, P.O. Drawer 15709, Tallahassee, Florida 32317-5709 �Yg�N �. g cal address: 325 John Knox Road, Building E, Suite 200, Tallahassee, Fiorida 32303. The form must be filed no later than the last day of the c e�darJ g 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 ` � 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) � � T _ � v � S � =- d v '^ O c� v' ' o N � � T C � r � w c�n `-^ N O w � � N J O � i � U'I �-mr O 3 lD vni . � � � � o D o � Q • O � j n j� .3-« � D 3 M � 'D a m 3 � � m y�N � � o 0 o m m m � � j � � a �. Q- � (D L� O fA Q „�. f C1 -+ � S � Q. 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'�:...Xy . f � P M ch M Y d' O w -D U o �.._ . � � � �`. v V w O _ � � m LL � � <.� W L u LL j � '� O � S N V C � N 3+ U m � tiL Q ` C a � _ , i o o � � o 0 � � V --- RJ fLJ s . • a a a a 0 0 � � �� � � � � � �� � �- Certified Mail Fee � �" $ � � Extl'8 SBNiCes 8i Fees (check bax, add /ee as appropriate) ❑ Retum Receipt Qiardcop� $ O Q ❑ Retum Receipt (electronic) $ POStrtlBrk O O � Certifled Mal Restricted Delivery g liere O O �AduR Signature Requked $ ❑ Adutt SlgnaWre Restricted Delivery $ p p Postage �7 v) 3 �� T� Florida Commission on Ethics � P.O. Drawer 15709 r` r` s a a Tallahassee, FL. 32317 - 5709 O O S •--------------- (�- C`- 'C "-""'-""'--' P