Micky Ross Steinberg - March 2014 Form 9 Form 9 QUARTERLY GIFT DISCLOSURE
(GIFTS OVER $100)
LAST NAME-FIRST NAME-MIDDLE NAME: NAME OF AGENCY:
:Ski',Ae,r!2j - -- &S S
MAILING ADD E S: OFFICE OR POSITION HELD:
CITY: ZIP: COUNTY: FOR UARTER ENDING(CHECK ONE): YEAR
j d f� ARCH ❑JUNE ❑SEPTEMBER ❑DECEMBER 20
61.1-4� �t
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
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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 STATE OF FLORID its 6O
COUNTY OF
depose on oath or affirmation and say that the information disclosed Sworn to(or affirmed)and subscribed before me this r
3 C3 day of 5 U N P, 20 IA
herein and on any attachments made by me constitutes a true accurate,
by 1 o r4 Be M�-
and total listing of all gifts required to be reported by Section 112.3148,
Florida Sta tes. (Signature of Nota blic-State of Florida)
(� A 3 L- CfUpw'f>J
(Print,Type,or Stamp Co issioned Name of Notary Public)
SIGNA U OF REPORTING OFFICIAL Personally Known IOR Produced Identification
Type of Identification Produced
PART D—FILING INSTRUCTIONS ,•; r RAFAELE GRANADO
r-r 046165
This form,when duly signed and notarized,must be filed with the Commission on Ethics,P.O.Dra 1, .. all sl� ;1 1� 3�7�Yb9 hysi-
cal address:3600 Maclay Blvd.South,Suite 201,Tallahassee,Florida 32312.The form must be fill ° �I�Of� ' 8f'Weuff WLNfta r arter
that follows the calendar uarter for which this form is filed(For example,if a gift is received in Marc ,i s ould be disclosed
,e,
CE FORM 9-EFF.1 WADD (See reverse side for instructions)
MY COMMISSION#FF 046165
ateS EXP IRES:September 16,2017
�b,p�5,�•`, Bonded Thru Notary Public LkWerwr*rs
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_ 2014
3-5 Jan Discovered the Dinosaurs Convention Center $108.00
9-Jan. Anthony& Cleopatra Colony $128.00
25-Jan. Disclosure Fillmore $56.00
30-Jan. Miami Beach Antique Show Convention Center $40.00(2 @20)
4-Feb. New Word School of Arts- Into the Woods Colony $42.00
13-Feb. International Boat Show Convention Center $120.00 (6 @20)
14-Feb. Lewis Black Fillmore $99.00
20-Feb. SOBEWFF Moet Hennessy's Ocean Drive $600.00
21-Feb. SOBEWFF Burger Bash Ocean Drive $450.00
21-22-Feb. SOBEWFF Grand Testing Willage Ocean Drive $450.00
22-Feb. Dance now I'l Mare Colony $60.00
22-Feb. Spirit Cheers Fla Nationals Convention Center $30.00
28-Feb. Into the Woods Fillmore $42.00
4-Mar. The Day It Snowed in Miami Colony $20.00
15-Mar. Miami Liryc Opera Colony $53.00