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Tathiane Trofino AMENDED County FormMIAMIBEACH OFFICE OF THE CITY CLERK City of Miami Beach, 1700 Convention Center Drive, Miami Beach, FL 33139 www. miamibeachfl.aov Telephone: 305.673-741 1 April 4, 2018 Miami -Dade Clerk of the Board of County Commissioners 111 NW 1st Street, # 17-10 Miami, FL 33128 Pursuant to Section 2-11.1(e)(4) of the Code of Miami -Dade County, attached please find an AMENDED copy of the Miami -Dade County Quarterly Gift Disclosure Form, for the quarter ending December 2017, for the following City of Miami Beach Personnel: Tathiane Trofino — Commission Aide (City of Miami Beach) The original has been filed with the Miami Beach Office of the City Clerk. Should you have any questions or require any additional information, please contact me at 305.673.7411. Respectfully, Rafael E.°Granado, City Clerk Attachments REG:cd Sent Certified Return Receipt 7017-1450-0002-2745-0012 MIAMI-DADE COUNTY QUARTERLY GIFT DISCLOSURE LAST NAME -FIRST NAME -MIDDLE NAME: 1Cr.)n Icti-hlane_ STREE ADDRESS: I/00 e01,-, ee4 bovc— CITY: Mi itt ISea(h ZIP: 3 3 S" COUNTY: tAltutti- ac� NAME OF AGENCY: 61- MicaY �cac OFFICE OR POSITION HELD: ConiinissioA FOR QUARTER ENDING (Check One): 0 MARCH 0 SEPT. 6-41/DEC. ❑ JUNE YEAR: 20 17 PART A: STATEMENT OF GIFTS. List below each gift, or series of gifts, from one person or entity in excess of $100, accepted by you during the calendar quarter for which this statement is being filed. Describe the gift and state the monetary value of the gift, the name and address of the person making the gift, and the dates the gifts were received. If any of these facts are unknown or not applicable, state this on the form. You are not required to file this statement for any calendar quarter during which you did not receive a reportable gift. DATE DESCRIPTION RECEIVED OF GIFT 10 /07 7/7 Lir13TQ' T,tc Fi =c Gu,1r— I l/ f t /17 I Dir Tower — TtC1(C) ,,) �/� J cI phc. &Fcti. Cum evidcit. II /01 /2(017 C'elc5,ahorL CHECK HERE IF CONTINUED ON SEPARATE SHEET. 0 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. 0 MONETARY NAME OF PERSON VALUE MAKING THE GIFT ADDRESS OF PERSON MAKING THE GIFT (700 (70/i i4.14,4•-• Crn+y totio t, -1csIn. Qd PART C: FILING INSTRUCTIONS. The signed and notarized form must be filed no later than the last day of the calendar quarter that follows the quarter for which this form applies. For example, if a gift is received in March, it should be disclosed by the end of the next quarter, i.e., June 30. County personnel file with the Clerk of the Board of County Commissioners, 111 NW 1't St., Suite 17-10, Miami, FL 33128. Municipal personnel file with their respective municipal clerks. PART D: OATH. I, the person whose name appears at the beginning of this form, do depose on oath or affirmation and say that the information disclosed herein and on any attachments made by me constitutes a true, accurate, and total listing of all gifts required to be reported by Section 2-11.1 (e)(4) of the Code. of Miami -Dade County. Sigrfature of Person Making Gift Disclosure COE 02/2010 STATE OF COUNTY OF FLORIDA'M /AAst (/l i° Sw rn to (or aff med) ajtd subscribed before me this day of , 20_ by Troc„A/0_, (Nat of Person Making Gift closure) (Signatorf Notary Public State of Florida) ei.,,, wAost,V (Print. Tvpc. or Stamp Commissioned Nanic of Nt tary Public) Personally known to me or 0 Produced Identification Type of Identification Produced: Charles J. DAgostin , NOTARY PUBLIC STATE OF FLORIDA Comm# GG168171 4'c CI Expires 12/14/2021 ENDER: COMPLETE TH S SECT! • u $z laa N > 0 c oo N 745, 0 rnv• O mo af¢ o EEg. ¢ Q Q o ) Z mt- `c c- m E. _2M.ii -am o o l7❑ Q �❑ • 2iDm tY�;jrm m cc .0 2mmmmm g,plm N E 3 ai¢tY0 It v1 v)¢ E m o — 0 0 o❑❑ ❑ ❑❑ o 1 • c mE 2-o -o > i~ m z 0 m 8m -0 -� a) m8 0 a) 2 C • a) as• o co V i V } CO t CO• X m • o o. v, L to a, a) C .,.. O - c4) --c +J an O -O - $ V --.In Ch N U Y E E -o masa �E C-0.0.0 v O m tv"' m 8' U C.) N C= o Q N ��+ O �w o C CD E E �� lc' • 9 o a) m' ea U cp . U .1.--: m • E m cn ,- SD.,'sm V• o O N O yQ iQ T al t G E y0c0 f6 O U Q m Q o¢ m ■ ■ o _ 00 N ri m J LL E 2 O e 00 ® C(00 mom O CO _ - (0 TO 00 —o O ® rn mow 0) O 2. Article Number (Transfer from service labell 2745 0012 m to0 0 0 Cu 0 rti r, � a T { O D 1 r -i r- rti 0 1-4 E ti 2745 0012 2745 0012 U.S. Postal Service"' CERTIFIED MAIL° RECEIPT Domestic Mail Only OFFICIAL Certified Mail Fee Extra Services & Fees (check box, add fee as appropriate) ❑ Return Receipt (hardcopy $ • O • ❑ Return Receipt (electronic) $ Postmark 0 Certified Mail Restricted Delivery $ Here USE ❑ Adult Signature RequiredCI 0 $ ❑ Adult Signature Restricted Delivery $ Postage $ Total Posta 7017 1450 7017 1450 Sent To Street and, City, State, Miami -Dade Clerk of the Board of County Commissioners 111 NW 1st Street, # 17-10 Miami, FL.33128