Micky Steinberg - December 2014 Form 9 ® ®
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MIAMIBEACH
OFFICE OF THE CITY CLERK
City of Miami Beach, 1700 Convention Center Drive, Miami Beach, FL 33139
www.miamibeachfl.gov
Telephone: 305.673-741 1
March 31, 2015
Florida Commission on Ethics
P.O. Drawer 15709
Tallahassee, FL 32317-5709
Pursuant to Sec. 112.3148, Florida Statutes, attached please find the original Quarterly Gift
Disclosure State Form (9), for the quarter ending December 2014, for Commissioner Micky
Steinberg of the City of Miami Beach.
Should you have any questions or require any additional information, please contact me at
305.673.7411.
Respectfully,
afael E. Granado,
City Clerk
Attachment
REG:clr
Sent Certified Return Receipt
F:ICLERI$ALLIGIFT DISCLOSURESI201414th Quarter Oct-DeclCommissioner Micky Steinberg.docx
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Form 9 QUARTERLY GIFT DISCLOSURE
,Y 's•K 4 .y
(GIFTS OVER $100)
LAST NAME--FIRST NAME--MIDDLE NAME: NAME OF AGENCY: �1
•
Siti r In�� `IrcL e1 I of f"j1 alyt Tae.Qclit
MAILING ADDRES4: I OFFICE OR POSITION HELD:
1700 e.on '1 . 0t') Cezr~ tr 1)y Coin rat ssi Qfrcr
CITY: ZIP: COUNTY: FOR QUARTER ENDING(CHECK ONES): YEAR
},i
MARCH JUNE SEPTEMBER U DECEMBER 20)9
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
VCHECK 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
COUNTY OF NA 1 IN-' i — DA O b
depose on oath or affirmation and say that the information disclosed Swo to(or affirmed)and subscribed before me this
31 day of ,Avf c ,20 15
herein and on any attachments made by me constitutes a true accurate,
by I" ("Lc- ST i Pi , ' '
and total listing of all gifts required to be reported by Section 112.3148,
Florida Stat tes. (Signat e of Notary Public-State of Florida)
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" (Print,T ;i&v.;. ,= p •':;ft-- 'W:ii r f Nary Public) = rc cv
SIGN
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OF REPORTING OFFICIAL Persona .. �..re: . a' ' gtif►sation - ..I
Type of,�= /tit i n fifiig �1a► PuAlic�►, � i9: m
PART D— FILING INSTRUCTIONS g
a$
This form,when duly signed and notarized,must be filed with the Commission on Ethics,P.O.Drawer 15709,Tallahassee,Florida 32317-5709;p .i- LL'
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 cale I 3 ;a�;
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.) :`:.-'a=�
CE FORM 9-EFF. 112007(Refer to Rule 34-7.010(1)(g),F.A.C.)(Rev.9/2014) (See reverse side for instructions) 1__;=:L.-1....;
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IMPORTANT: Save this receipt and present it when making an inquiry. - 0_ ea ,
PS Form 3800,August 2006(Reverse)PSN 7530-02-000-9047 p :.
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