Dan Gelber Form 9 QTR 4 MIAMIBEACH
OFFICE OF THE CITY CLERK
City of Miami Beach, 1700 Convention Center Drive, Miami Beach, FL 33139
www.miamibeachfl.gov
Telephone: 305.673-7411
March 28, 2019
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 December 2018, for the following City of Miami Beach Personnel:
• Dan Gelber— City of Miami Beach (Mayor)
• John Elizabeth Aleman — City of Miami Beach (Commissioner)
• Ricky Arriola —City Of Miami Beach (Commissioner)
Should you have any questions or require any additional information, please contact me at
305.673.7411.
Respectfully,
7
Rafael E. Granado,
City Clerk
Attachment
REG:cd
Sent Certified Return Receipt
9214-8901-9403-8380-6077-85
City of Miami Beach USPS CERTIFIED MAIL
City Clerk
1700 Convention Center Dr
Miami Beach Fl 33139
9214 8901 9403 8380 6077 85
FLORIDA COMMISSION ON ETHICS
PO Box 15709
TALLAHASSEE FL 32317-5709
Fold Here
Return Reference#:State Gift Disclosure
Username:Charles Dagostin
Code Violation#:
Court Case#:
Property Address::
Permit ID#:
Custom 5:
Postage:$5.7500
Form 9 QUARTERLY GIFT DISCLOSURE 1 § Pay
(GIFTS OVER $100)
LAST NAME--FIRST NAME--MIDDLE NAME: NAME OF Ati lt' 2 P
ri-eA9r, rtit 1'> I Gig 1cuon Oect c
MAILING ADDRESS: FFI POSITION H D:
O CE REL
no o co n• c 'r+ Dr\ Ce�rt-c_i��r t'.&c1\XCkt o r
CITY:, ZIP: COUNTY: FOR QUARTER ENDING (CHECK ONE): YEAR
i\Jk � � t Y`�. % ❑MARCH ❑JUNE SEPTEMBER ECEMBER 20j'
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
..rJa`'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.
0 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 FLORIDA
COUNTY OF t1/4-4 ttiti.4
depose on oath or affirmation and say that the information disclosed Sworn to(or a armed)and subscribed before me this
2. day of ` £,V. 20 _
herein and on any attachments made by me constitutes a true accurate, 6ib1
by pieLii O
and total listin• • -allgifts required to be reported bySection 112.3148 '
q p
.„(
Florida atutes. (Signature of Notary _ublic-State of Florida)
(Print,Type,or Stamp Co i• . • Na' .‘ �_ :' ' 4fPEPorida
SIGNATURE OF REPORTING OFFICIAL Personally Known,-.. •" a --' :
Type of Identification Prod e•• . • y
•
• OG 044249
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: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.1/2007(Refer to Rule 34-7.010(1)(g),F.A.C.)(Rev.6/2016) (See reverse side for instructions)rte'
DATE GIFT ESTIMATED VALUE DONOR/GOVERNMENT
10/1/2018 10 Auto Show Tickets $10 each ($100) Auto Show
10/6/2019 LGBTQ Task Force Gala $100 each ($200) LGBTQ
11/5/2019 GMCVB/NFL Media Trip $100.00 NFL
11/26/2019 Dinner $150.00 Smith &Wollensky
12/4/2018 Pulse Art Fair $200.00 Pulse Art Fair
12/4/2018 Scope Art Fair $175.00 Scope Art Fair
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