Deede Weithorn - March 2015 Form 9 ....
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Form 9 QUARTERLY GIFT DISCLOSURE
(GIFTS OVER $100) •
LAST NAME-FIRST NAME-MIDDLE NAME: NAME OF AGENCY:
Wejthorrl1 Dgc1 ' ( 1t\j of 1�1jGm.1 -Beach
MAILING ADDRESS: OFFICE OR POSITION HELD:
11 W sii 11 fate,r Dri & Comm �ssioner
CITY: ZIP: COUNTY: F R QUARTER ENDING(CHECK ONE): YEAR
• • A/lARCH ❑JUNE ❑SEPTEMBER ❑DECEMBER 20 ■S
M i d rn 1 beach , FL Aliamf .lade —
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
P 1 ea e 5 0& q 1-1-a Ch rc end".
March 2(o, 201S Ci-) C-en t-C,f n 10 I (a--) 0voo Mayor Ph; ii p 1 ioo con ye.n-tion
7i C K-etS JSo a c.r� Le v i fl c Cn to r t)I i ve
f - b. 2'-J, 2.01S-(ti)P U r i m �C1 11 C�-) Jt�i s r
2.als DSO oG M U&e�m 0f
e.CLCh rrtori da- F1k.
—
X 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
. PARTC—OATH
I,the person whose name appears at the beginning of this form,do STATE OF FLORIDA
COUNTY OF M ;am4 -Dade
depose on oath or affirmation and say that the information disclosed Swor to or affirmed)and subscribed before me this
day of 75-01-N e. ,20 1 S
herein and on any attachments made by me constitutes a true accurate, - 1D
y e ' Wei rho
and total listing of all gifts required to be reported by SPrtinn 112 314R R
LAYDA HERNAN).' A I
Florida Statutes. o`..'�`Y I6� R ig nr- •Ary'•lic-State• �•nda)
_; ,� MY COMMISSION#FF025489 �-
EXPIRES:JUN 09,2017
l'ec"ricr Bonded through 1st State
rin,aiype,or Stamp Commissioned Name o.Notary Pu,lic)
SIGN TUa�R1�E((•OOFn�REP TING FFICIAL Personally Known OR Produced Ide 'fication
Type of Identification Produced
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: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)
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