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Joy Malakoff Form 9^� ^' �`� �� ^: ! B EAC 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: • Joy Malakoff — Commissioner, 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) ��j� ��p �� �� a, �� LAST NAME -- FIRST NAME -- MIDDLE NAME: NAME OF AGENCY: ' �i' t�i�r�ta'1� ��.QC� Malakoff, Jov V.W. Citv of Miarni±�ea Cg�4-- -r, m ` . . � -.// �-;\ � .s � �. /.`, � j # '., l,. i: i � f�, MAILING ADDRESS: OFFICE OR POSITION HELD: 1700 Convention Center Drive. 4th floor Commissioner CITY: ZIP: COUNTY: FOR QUARTER ENDING (CHECK ONE): YEAR ❑MARCH �LIUNE ❑SEPTEMBER ❑ DECEMBER 2017 Miami Beach 33139 Miami-Dade PART A— STATEMENT OF GIFTS Please list below each gift, the value of which you believe to exceed $100, accepted by you during the cafendar 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 fuily 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 Ce, �3� ao��l DESCRIPTION MONETARY NAME OF PERSON ADDRESS OF PERSON OF GIFT VALUE MAKING THE GIFT MAKING THE GIFT MBCC Gala Ticket for Fred ��� �� R-� City of Miami Beach 1700 Convention Drive, Malakoff I/ 4th Floor, Miami ❑ 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. ❑ 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 depose on oath or affirmation and say that the information disclosed herein and on any attachments made by me constitutes a true accurate, and total listing of all gifts required to be reported by Section 112.3148, Florida Statutes. ? % � � /� l�v�if�.�,�/ �8'NAT�E OF R�ORTING OF�ICI� / STATE OF FLORID COUNTY OF �iiA�.X-�f. — � Sworn to (or affirmed) and su�ri e befor me is �j�l day of , 20 i � by / � ^I � ' �(�• •a�Cffe ��i -'Si�dt�'��I°�r:) = �' � `' EXPIRE ; vemDer 1 2020 �S�%;a �;°:'' Boncled Thru Notety PuhGc Unde+wAlers ,. �. .�.. � � �� � ��� � �, ,�.� ,� ,.. (Print, Typ , of otamp l;ommissioned iJam'e"o� �Votary ��lic) Personally Known CIOR Produced Identification Type of Identification Produced 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: 325 John Knox Road, Building E, Suite 200, Tallahassee, Florida 32303. 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 fiied (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) `� � 0 � _ _ — — _ _ . _ _ _ _ _ �N . ■ e � �,� e D ODo�(� -� o CQ � �i O p� -+ � � m c3i � —i � o � � � '. � LJ"1 z�� flJ � D s p� .� � � c O— n� � a m?�_ � � m J� v�� y D� o� m ta � � O � � O C'� m .'. � � � O a �, fl. RJ y 1� � �� O aIQ ��' i� p _ T � � N s� Q. iv � N m (q -� � � W� �. W 6�� a � � � W � 7 � .nT pnj t�A <°) N � C9 — V O j tn ��O � `D -P — � tD m 3 0 �, —�m �� v � � �� —0 = v °_� O n' � m �1 = lD �^ a � � � � n � m m ❑���D�OC�ca 'm� oommaaln � 07 � D c c�� M� µ c t0 --�, w ]7' Cn �aa».".mmrncn� m oo�-a�co m m� � � �cu°=00pmmm —i �< <� S� �( m m--' C c� �p N" N _ Np N (�D� (�D � (� m m 7 `�^ �- � Z � » � m p-' 6. a � � � m� �` a m <—�' �I m � o a W a m' m a < � � � n � m z m Q� � < a w m m �. `� N � U � ❑❑ L ��❑ (D _. . �m�'�m��x(p� � 3 y(� tL� N C =1f] �II O 1 (� :. n C C fl 3� N N� -J. °-� m °-��Q�a� ��� OOm � �❑ m ❑� m??ma m�z Z-G o D D m� 3 a 31 3� O N � �. (D � m.�s N y � CJ w��i O O o � � y 3 � 3 a '� ry P M C'7 C') Y � o w � U `o r u- � _ U � w � = m H � � 0 .� w � V � u. > LL- '� � � 1 � V C � U m � E � o � � o Q U �o 0 V ^ �' �' e . � . • Q' 0"' O � s�'��°�°�i'►diui,in�::,dl.�nei'%e:i�'�:} ���'I�a�.i:ih�<i���.a.��e� i7':,a�h.,����.1�� L] � � �,.�,� � � � z „z � � � �y� � �,f� � � �' � `��c.,. _ � �:� -�' �a � vr . � ✓ `n�-:� � � Certlried Maif Fee I`- [`- g N� F�ctra Services 8 Fees (cneck oac, add fee as a,opropnate) ❑ Retum Receip: {hardcoP» $ � � ❑ Retum Receipt {elechonic) S Postmark � � ❑ Certifled Maii Restricted Delivery $ HBfe � � ❑ Aduk Signature Required $ � � � Adult Signature Res4icted Deiivery $ a o P�99 i u� u� � �� TotalP Florida Commission on Ethics � P.O. Drawer 15709 ['� (�- Sent R 0 o Si�ee�: Tallahassee, FL. 32317 - 5709 .._..._ � � ,C'ry-St """' �itasr:t.t���l:7ilrl��i�7'i.'I+�li/.�c!S;i a J_If�sme�'P�.t-a�ta,� aui,l�lf� iiRHiC•� LL F"