Loading...
Ed Tobin September 2013 Copy 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 ENDI (CHECK ONE): YEAR MIAMI BEACH, FL 33139 DADE ❑MARCH ❑JUNE EPTEMBER ❑DECEMBER 20_3 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 L a3� ❑ 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 13"SIREE KANE NOTARY STATE OF FLORIDA PART C—OATH o Comm*EE041861 I,the person whose name appears at the beginning of this form,do STATE OF FLORIDA @S 5/201 COUNTY OF M1 Git\l depose on oath or affirmation and say that the information disclosed Sworn to(or affirmed)and bscribed before me this BCD �% day of��>�/L 20 l herein and on any attachments made by me constitutes a true accurate, �\ by 1 lP��l►�'e,� and total listing of all gifts required to be reported by Section 112.3148, Florida Statutes. 04/1"f Notary Public-State of Florida) (Print,Type,or Stamp Commissioned Name of Notary Public) SIGNATU F REPORTING OWInAL Personally Known )( OR Produced Identification Type of Identification Produced r 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:36DO 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 July—September 2013 City of Miami Beach Mayor and Commission Office DATE EVENT VALUE 7/13/13 Air Suppy Provided by City of Miami Beach 1700 Convention Center Dr. Miami Beach, FL 33139 2 tickets @ $83.50 ea. $177.00 8/16/13 Priceless Miami Justin Timberlake Provided by City of Miami Beach 1700 Convention Center Dr. Miami Beach, FL 33139 2 tickets @ $99.50 ea. $199.00 8/30/13 Bellydance Evolution Provided by City of Miami Beach - 1700 Convention Center Dr. Miami Beach, FL 33139 2 tickets @ $50.00 ea. $100.00 9/07/13 International Ballet,Festival of Miami Provided by City of Miami Beach 1700 Convention Center Dr. Miami Beach, FL 33139 2 tickets @ $68.50 ea. $137.00 9/08/13 International Ballet Festival of Miami Provided by City of Miami Beach 1700 Convention Center Dr. Miami Beach, FL 33139 2 tickets @ $68.50 ea. $137.00 9/20/13 Tumi Awards Gian Marco Provided by City of Miami Beach 1700 Convention Center Dr. Miami Beach, FL 33139 2 tickets @ $60.00 ea. $120.00 9/28/13 Alejandra Ascarate Provided by City of Miami Beach 1700 Convention Center Dr. Miami Beach, FL 33139 2 tickets @ $50.00 ea. $100.00 9/28/13 Gad Elmaleh Provided by City of Miami Beach 1700 Convention Center Dr. Miami Beach, FL 33139 2 tickets @ $88.50 ea. $177.00 sr'�I�A '1 fe" ` 106 A°' IP R120 ° .00 tAx 0.00 0.0 GENERAL ADMISSN . $; • CN 42795 M qt7_- ENADM I _ `� T U tJp l PRESE A Y YO'* 602TOC N 1000 m A ARCO _ - COL NY THEA 0.00 � } JOC123 = C29AUG FRI SEP 20 2013 7, PM 10 0 6 JIM M7 ADM ti Ax 0 .00 GENERAL ADMISSN 4; CN 53803 _ r-= ENADM f. 17C r.. , . TU OD NT Y p.. • 602TOC a) -PRESEN r� s_ GI MA CO COLO THEATRE 0 .00 OD TOC123 N w, { FRI SEP 20 2013 7',00 M -' 1007 =A C29AUG =_