Jose Smith - September 2013 Form 9 •
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Form 9 QUARTERLY GIFT,plcilepSURE
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LAST NAME-- FIRST NAME--MIDDLE NAME: .,. `'Nf 1V1e lkdENCY:
Smith,Jose CST City of Miami Beach
MAILING ADDRESS: OFFICE OR POSITION HELD:
1700 Convention Center Drive,4th Floor City Attorney
CITY: ZIP: COUNTY: FOR QUARTER ENDING (CHECK ONE): YEAR
Miami Beach 33139 Miami-Dade ❑MARCH ❑JUNE SEPTEMBER ❑ DECEMBER 20 13
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 Exhibit
® 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 FL DA
COUNTY OF iam-Dade
depose on oath or affirmation and say that the information disclosed Sworn to(or affirmed)and subscribed before me this
2-6412 day of Septemher ,20 13
herein and on any attachments made by me constitutes a true accurate,
by 11 1_ n
and total listing of all gifts required to be reported by Section 112.3148, I N �IF � ��
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Florida Statutes. (Sig ature of ot`r v, tM 0,, )
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SIG ATUR-OF °•' ING OFFICIAL Personally Known Y 033*roduca2d kde fcZtiot
'" Type of Identification Produce z •*
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PART D—FILING INSTRUCTIONS '�i.o'°:d Pain►ura'o.•'�,
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This form,when duly signed and notarized,must be filed with the Commission on Ethics,P.O.Drawer 15709,TallahasVAY �ponda 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)cam'
, ' - `.`
Over a$100
Date Description Monetary Name of person Address of person
Rec. of gift Value making the gift making the gift
City of Miami Beach 1700 Convention Center Drive
Miami Beach,FL
•
6-3-13 Miami Beach $600.00 " " " -- G4 " " " -- 44
Chamber Gala
6-27-13 Air Supply $177.00 " " " -- G4 "-GC CC -- CC
6-27-13 Julio Sabala $127.00 " " " -- CG " " " -- 44
6-27-13 Maria Gadu $138.00 "-C4 " -- GC "-GC CC -- GC
8-13-13 After Show with $199.00 " " " -- G4 "-C4 CC -- "
Justin Timberlake
8-13-13 XVIII International $137.00 " " " -- " " " " -- "
Ballet Festival of Miami
9-7-13
8-13-13 XVII International $137.00 "-C4 " -- GC " " " -- 44
Ballet Festival of Miami
9-8-13
8-13-13 Gad Elmaleh $177.00 " " " -- " " " " -- GC
9-12-13 Robertico $120.00 "—" " -- GC "-CC 4G -- CC
9-12-13 Alejandra Ascarate $100.00 "—" CC -- " " " -- GC
9-12-13 Gian Marco $120.00 "-GC " -- " " " " -- 4,
9-12-13 Draco Rosa $127.00 " " 44 -- " " " -- CG
"Vida Tour"
9-12-13 Cristian Castro $127.00 "—" " -- ,, "-4, CC -- C4