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Ed Tobin June 2011 Form 9 QUARTERLY GIFT DISCLOSURE (GIFTS OVER $100) LAST NAME – FIRST NAME – MIDDLE NAME: NAME OF AGENCY. TOBIN, ED CITY OF MIAMI BEACH MAILING ADDRESS: OFFICE OR POSITION HELD: 1700 CONVENTION CENTER DRIVE COMMISSIONER CITY: ZIP: COUNTY: FOR QUARTER ENDING (CHECK ONE): YEAR MIAMI BEACH, FL 33139 DADE ❑MARCH JUNE ❑SEPTEMBER ❑ DECEMBER 20 ` 1 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 SEE ATTACHED ❑ CHECK HERE IF CONTINUED ON SEPARATE SHEET (--) -� zs C) PART B — RECEIPT PROVIDED BY PERSON MAKING THE GIFT r N -I 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 o that rec eipt to4his form. You may attach an explanation of any differences between the information disclosed on this form and the information theceip ❑ CHECK HERE IF A RECEIPT IS ATTACHED TO THIS FORM rio C W PART C — OATH I, the person whose name appears at the beginning of this form, do STATE OF FLORI�D�. COUNTY OF f IiorN.--Cl ' � depose on oath or affirmation and say that the information disclosed Sworn to (or affirmed) and subscribed before me this day of !)Q , 20 C ) herein and on any attachments made by me constitutes a true accurate, II _ -1� by 1 c A:31h and total listing of all gifts required to be reported by Section 112.3148, 2eLt Florida Statutes (Signature of Notary Public -State of FI ida / 411 / (Print, Typ: • i SIGNATURE O ' ' • RTING • IAL Personal/ � - . -��T I.�� Type of Id. r . - .: - . r !! eiiimission 100 MO PART D — FILING I N S T R 4 gaimiumehimmeNifty 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) ''° • FORM 9 QUARTERLY GIFT DISCLOSURE (ATTACHMENT) RE: Commissioner Ed Tobin Ticket Distribution for April — June 2011 City of Miami Beach Mayor and Commission Office DATE EVENT VALUE Apr. 14 Beach Boys Provided by City of Miami Beach 1700 Convention Center Dr. Miami. Beach, FL 33139 2 tickets @ $148.00 ea. $296.00 Apr. 16 Bill Frisell Provided by City of Miami Beach 1700 Convention Center Dr. Miami Beach, FL 33139 2 tickets @ $50.00 ea. $100.00 May 7 Amau:ry Gutierrez Provided by City of Miami Beach 1700 Convention Center Dr. Miami Beach, FL 33139 2 tickets @ $73.00 ea. $146.00 May 14 C.O.M.B. (La Faille Mal Gardee) Provided by City of Miami Beach Miami Beach, FL 33139 4 ticket @ $66.50 ea. $266.00 June 04 Guest ticket for the Miami Beach Chamber Gala Provided by City of Miami Beach 1700 Convention Center Dr. Miami Beach, FL 33139 1 tickets @ $250.00ea. $250.00 June 11 Diego Torres Provided by City of Miami Beach 1700 Convention Center Dr. Miami Beach, FL 33139 2 tickets @ $56.50 ea. $113.00