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Liliam R. Hatfield - June 2015 Form 9
Form 9 QUARTERLY GIFT DISCLOSURE (GIFTS OVER $100) LAST NAME--FIRST NAME--MIDDLE NAME: NAME OF AGENCY: HATFIELD, LILIAM ROSA CITY OF MIAMI BEACH MAILING ADDRESS: OFFICE OR POSITION HELD: 1700 Convention Center Drive Assistant City Clerk CITY: ZIP: COUNTY: FOR QUARTER ENDING (CHECK ONE): YEAR Miami Beach, Fla 33139 Miami-Dade ❑MARCH EIJUNE OSEPTEMBER ❑DECEMBER 20 15 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 03.26.2015 ' Hard Rock Rising Concert $1,080 Alb Angel 605 Lincoln Road Red Fi sh Media ;-- r—.a — (ri ,`y r.i ❑ CHECK HERE IF CONTINUED ON SEPARATE SHEET . r. _ ei^ 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 FLORA°` AnA tjc °�COUNTY OF P®r?�11, �s �"depose on oath or affirmation and say that the information disclosed Swo (or affirmed)ands ribed before me this h S v)„, o:o G4 day of Lim, ,20 1 i t herein and on any attachments made by me constitutes a true accurate, L,.. . — N go by �a I i :Ll! 1 and total listing of all gifts required to be reported by Section 112.3148, r�"' » Florida Statutes. (Signature of Notary Public-State of Florida) .1 8.o c� Ar ' . 'f ., �� . �� '`%�� (Print,Type,or Stamp Com ssioned Name of Notary Public)'` X40,4 °„',Pee.,� SLG : °E OF REPORTI G !FFICIAL Personally Known O R Produced Identification 4 la S�V Type of Identification Produced $/. PART D— FILING INSTRUCTIONS A o 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)''' r Y , r Hard Rock Rising Miami Beach Global Music Festival 2015 - Tickets - Miami Beach Ce... Page 2 of 2 ('<a-) 14-el lei Me ee�G. T CLUB SUfTES w' PRIIATESJrES $55 .: $129 $540 _: (Individual Seating) ' r _._. 4 _ EPEE 1 FRS , A,,r, ' ,717, Qg Ina MAIN BEACH f 11AMl.BEACH i 1 $79 $179 $1 ,000 V1E' _ H. REIfaE ',°4 l r 4 "::�.< ,'S AGE .•AREA A. _ .. ...._. ,AREA t ?C �, a '° i0" w $105 at$365 Call: (305) 341-7899 CLUB SUITES - ▪ 7a (oostruc:ea) (Individual Seating)w' "fir-4-rt Vr• TiS;• Copyright©2015 Ticketfly,Inc. fly --- . < Y_ :: ., - __- Sec: 1 1 1 w Row:F Seat '_`_:- *'_., 1 C'.:I._ a tjr119 .:... .., COMP o 4R N • VAfa ........= Rock Rising ng —'� it Hard Mi am � O M 2015 - ° =ti il GLobaL Music Fest ivaL ° Miami Beach Centennial' 2015 t N s— =�r. 8th Street at Ocean Drive hiiami Beach, FL r.� ° .moo Mar 2015 5:00 PM "'O Thu Mar 26, - N Price:$O.00 No Re-Entry.No Coolers.GA Areas Beach Chairs Allowed 1 Per Person - 3473 -. it Order:096899584464 Purchased By Order Comp 4_._ .=: tea ---_ . ., -_ , '.''_ . -'. 7.Sec: 1 12 n ® Rot�i F, Seat :21 ' _ COMP A o w a • Hard Rock Rising Miami Beach: , E .�� `n � —� • GLobal Music Festival. -2015. :::..H:::. " ° Miami Beach Centennial 2015 y ;' N • 8th Street at Ocean Drive Miami -Beach, FL o _o - L` Thu Mar 26, 2015 5:00 PM a..) (NI Price:$0.00 v, 1 No Re-Entry.No Coolers.GA Areas Beach Chairs AL,Lowed 1 Per Person Order:096899584464 Purchased By:Order.Comp - 3474