Erick Chiroles County Form MIAMI BEACH
OFFICE OF THE CITY CLERK
City of Miami Beach, 1700 Convention Center Drive, Miami Beach, FL 33139
www.miamibeachfl.gov
Telephone: 305.673-7411
September 28, 2018
Miami-Dade Clerk of the
Board of County Commissioners
111 NW 1st Street. # 17-10
Miami. FL 33128
Pursuant to Section 2-11.1(e)(4) of the Code of Miami-Dade County, attached please find a copy
of the Miami-Dade County Quarterly Gift Disclosure Form, for the quarter ending June 2018, for
the following City of Miami Beach Personnel:
Erick Chiroles — Commission Aide (City of Miami Beach)
The original has been filed with the Miami Beach Office of the City Clerk.
Should you have any questions or require any additional information, please contact me at
305.673.7411.
Respectfully,
721
Rafael E. Granado,
City Clerk
Attachments
REG:cd
Sent Certified Return Receipt
7017-1450-0002-2744-0365
MIAMI-DADE COUNTY
QUARTERLY GIFT DISCLOgii ;' 28 PM is: 32
LAST NAME-FIRST NAME-MIDDLE NAME: NAME OF AGENCY: • • +
l lilro)PS !rs(1c� Ct} O1 / itowt; Beach
ST
E ADDRESS: �1 OFFICE 001k POSITION HELD:
3'3 0 l�Ilc,/i t4 Aver Ati /0,1_ /1 i' /
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CITY: M�qt i Qeq cl^ FOR QUARTER ENDING(Check One):
ZIP:33/3a 0 MARCH E JUNE
COUNTY: M,Arvt'— Dowle 0 SEPT. 0 DEC. YEAR:20 /8'
PART A: STATEMENT OF GIFTS. List below each gift,or series of gifts,from one person or entity in
excess of$100,accepted by you during the calendar quarter for which this statement is being filed. Describe the gift
and state the monetary value of the gift,the name and address of the person making the gift,and the dates the gifts
were received.If any of these facts are unknown or not applicable,state this on the form.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
V/2,14 l fp e Mer e A"�(ItYis 1J /f e Melfi x, li
333 Po de Leonv4S
B) 4•Le900
VX� Tc�iet !/ y( � PrmertCaS1LGC Cora\&'toA S) FL 33(3f
CHECK HERE IF CONTINUED ON SEPARATE SHEET. 0
PART B: RECEIPT PROVIDED BY PERSON MAKING THE GIFT. If any receipt fora 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. 0
PART C: FILING INSTRUCTIONS. The signed and notarized form must be filed no later than the last day
of the calendar quarter that follows the quarter for which this form applies.For example,if a gift is received in March,
it should be disclosed by the end of the next quarter,i.e.,June 30.County personnel file with the Clerk of the Board
of County Commissioners, 111 NW lst St.,Suite 17-10,Miami,FL 33128.Municipal personnel file with their
respective municipal clerks.
PART D: OATH. Ote04._I, the person whose name appears at the beginning of STATE OF FLOrti this form, do depose on oath or affirmation and say COUNTY OF ��((//CC CTt" /
that the information disclosed herein and on any
attachments made by me constitutes a true, accurate, to(or aff •.)a s. subscrib fore me this
and total listing of all gifts required to be reported by O'- day of AP ,20
Section 2-11.1 (e)(4) of the Code of Miami-Dade
County. by — • !(d le S
N. .f Person• .king Gi •
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'attire of No Public.State of Florida)
Signature of Person Making Gift Disclosure ` / ( S
(Print.Type,or Stamp Commissione.dT.me of Notary Public)
Personally known to me or 0 Produced Identification
Type of Identification Produced:
Charles J.DAgostin
( . • NOTARY PUBLIC
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