Kristen Rosen Gonzalez Form 9 QTR 3 2018OFFICE OF THE CITY CLERK
City of Miami Beach, 1700 Convention Center Drive, Miami Beach, FL 33139
www.miamibeachfl gov
Telephone: 305.673-7411
December 28, 2018
Florida Commission on Ethics
P.O. Drawer 15709
Tallahassee, FL 32317-5709
Pursuant to Sec. 112.3148, Florida Statutes, please find a Quarterly Gift Disclosure State Form
(9), for the quarter ending September 2018, for the following City of Miami Beach Personnel:
• Kristen Rosen Gonzalez — Commissioner (City of Miami Beach)
Should you have any questions or require any additional information, please contact me at
305.673.7411.
Respectfully,
'iW�Rafaal Ea Grano, ~ �'
ity Clerk
Attachment
REG:cd
Sent Certified Return Receipt
Form 9 QUARTERLY GIFT DISCLOSURE
(GIFTS OVER $100)
LAST NAME -- FIRST NAME -- MIDDLE NAME:
NAME OF AGENCY:
Gonzalez Rosen, Kristen
City of Miami Beach
MAILING ADDRESS:
OFFICE OR POSITION HELD:
4618 Alton Road
Commissioner
CITY: ZIP: COUNTY:
FOR QUARTER ENDING (CHECK ONE): YEAR
Miami Beach 33140 Miami -Dade
❑MARCH ❑JUNE idSEPTEMBER ❑ DECEMBER 20_1a
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
07/18/18
Culinary & Arts Event
100.00
Rosen Gonzalez
4618 Alton Road
Miami Beach, FL 33140
08/17/18
Hispanic Women's Society
100.00
Rosen Gonzalez
4618 Alton Road
Luncheon
Miami Beach, FL 33140
08/21/18 & 08/24/18
CGCG Women's Bt Iciness Network Luncheon
150.00
City of Miami Beach
1711" Convention Center Dr.
cGCC Aannal Conf Luncheon
150.00
Mayor & Comm. office
Miami Beach, FL 33139
08/24/18
Latin Builders Luncheon
150.00
LB Assoc.
11093 NW 138th Street
Hialeah. FL 33018
[11 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 IFA RECEIPT IS ATTACHED TO THIS FORM
PART C — OATH
1, 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 all gifts required to be reported by Section 112.3148,
Florida�ta t'
SIGNATUf - EOR 1WG OFFICIAL
STATE OF COUNTY OF ORI_ /I I;
Sw n r affrmed)
and subscribed before Fme his
day of �I— 20
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by JSr'U
6Q_ Al /t—z
, Type, orSlamp Cor
orally Kno_
of Identifi ation Produ
PART D — FILING INSTRUCTIONS
STATE OF FLORIDA
L7
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: 325 John Knox Road, Building E. Suite 200, Tallahassee, Florida 32303. 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. 112007 (Refer to Rule 34-7.010(1)(g), F.A.C.)(Rev. 6/2016) (See reverse side for instructions) '�'_
Quarterly Gift Disclosure
Gonzalez Rosen, Kristen
Quarter Ending September 2018
9/21/2018 City Nat'l Bank RE Luncheon CMB Mayor & Comm. 150.00
9/28/2018 LBA Awards Luncheon LB Assoc. Hialeah 150.00
City of Miami Beach
City Clerk USPS CERTIFIED MAIL
1700 Convention Center Dr
Miami Beach FI 33139
9214 8901 9403 8376 82:910 30
FLORIDA COMMISSION ON ETHICS
PO Box 15709
TALLAHASSEE FL 32317-5709
Return Reference#:
Username: Charles Dagostin
Code Violation #
Permit ID #:
Court Case #
Custom 4:
Custom 5:
Postage: 5.42