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Michael Gongora Form 1F QTR IVFORM 1F FINAL STATEMENT OF 2021 FINANCIAL INTERESTS (TO BE FILED WITHIN 60 DAYS OF LEAVING PUBLIC OFFICE OR EMPLOYMENT) LAST NAME — FIRST NAME — MIDDLE NAME: NAME OF REPORTING PERSON'S AGENCY: Gongora Michael City of Miami Beach MAILING ADDRESS: CHECK ONE OF THE FOLLOWING (see "Who Must File" on page 3): 5838 Collins Avenue ❑ LOCAL OFFICER ❑ STATE OFFICER ❑ SPECIFIED STATE EMPLOYEE LIST OFFICE OR POSITION HELD: Miami Beach Commissioner CITY: ZIP: COUNTY: Miami Beach 33140 Miami Dade `BOTH PARTS OF THIS SECTION MUST BE COMPLETED` DISCLOSURE PERIOD: THIS STATEMENT REFLECTS MY FINANCIAL INTERESTS FOR THE PERIOD BETWEEN JANUARY 1, 2021 AND THE LAST DATE I HELD THE PUBLIC OFFICE OR EMPLOYMENT DESCRIBED ABOVE, WHICH DATE WAS November 22, 2021 2021. (Date must be prior to 12/31/21) MANNER OF CALCULATING REPORTABLE INTERESTS: FILERS HAVE THE OPTION OF USING REPORTING THRESHOLDS THAT ARE ABSOLUTE DOLLAR VALUES, WHICH REQUIRES FEWER CALCULATIONS, OR USING COMPARATIVE THRESHOLDS, WHICH ARE USUALLY BASED ON PERCENTAGE VALUES (see instructions for further details). PLEASE STATE BELOW WHETHER THIS STATEMENT REFLECTS EITHER (must check one): ❑ COMPARATIVE (PERCENTAGE) THRESHOLDS OR ✓❑ DOLLAR VALUE THRESHOLDS PART A -- PRIMARY SOURCES OF INCOME [Major sources of income to the reporting person - See instructions] (If you have nothing to report, write "none" or "n/a") NAME OF SOURCE SOURCE'S DESCRIPTION OF THE SOURCE'S OF INCOME ADDRESS PRINCIPAL BUSINESS ACTIVITY Becker Alhambra Towers 121 Alhambra Plaza Condo Law 10th Floor Coral Gables, FL 33134 PART B -- SECONDARY SOURCES OF INCOME [Major customers, clients, and other sources of income to businesses owned by reporting person - See instructions] (If you have nothing to report, write "none" or "n/a") NAME OF NAME OF MAJOR SOURCES ADDRESS PRINCIPAL BUSINESS BUSINESS ENTITY OF BUSINESS' INCOME OF SOURCE ACTIVITY OF SOURCE N/A PART C -- REAL PROPERTY [Land, buildings owned by the reporting person - See instructions]FILING INSTRUCTIONS for when (If you have nothing to report, write "none" or "n/a") and where to file this form are located at the bottom of page 2. 5838 Collins Ave #3A Miami Beach, FL 33140 INSTRUCTIONS on who must file 600 NE 36th Street Apt 1902 Miami, FL 33137 this form and how to fill it out begin on page 3 of this packet. Vacant Land in Sebring, FL See attachment for additional property CE Forth 1F Effective: January 1, 2021 (Continued on reverse side) PAGE 1 Incorporated by reference in Rule 34-8.208(2), FA.C. PART D — INTANGIBLE PERSONAL PROPERTY [Stocks, bonds, certificates of deposit, etc. - See instructions] (If you have nothing to report, write "none" or "nia") TYPE OF INTANGIBLE See attachment BUSINESS ENTITY TO WHICH THE PROPERTY RELATES PART E — LIABILITIES [Major debts - See instructions] (If you have nothing to report., write "none" or "nla") NAME OF CREDITOR ADDRESS OF CREDITOR Wells Fargo- Mortgage 1420 Montgomery St. San Francisco, CA 94104 Bank of America 16000 Feldwood Road College Park, GA 30349 PART F — INTERESTS IN SPECIFIED BUSINESSES [Ownership or positions in certain types of businesses - See instructions] (If you have nothing to report, write "none" or "n/a") BUSINESS ENTITY # 1 (NAME OF BUSINESS ENTITY I N/A OF BUSINESS ENTITY PRINCIPAL BUSINESS ACTIVITY POSITION HELD WITH ENTITY I OWN MORE THAN A 5% INTEREST IN THE BUSINESS NATURE OF MY OWNERSHIP INTEREST BUSINESS ENTITY # 2 IF ANY OF PARTS A THROUGH F ARE CONTINUED ON A SEPARATE SHEET. PLEASE CHECK HERE 1-1 SIGNATURE OF FILER: Signature: ate Signed: WHEN TO FILE: At the end of office or employment each local officer, state officer, and specified state employee is required to file a final disclosure form (Form 1F) within 60 days of leaving office or employment, unless he or she takes another position within the 60 -day period that requires filing financial disclosure on Form 1 or Form 6. WHERE TO FILE: Local officers file with the Supervisor of Elections of the county in which they permanently reside. (If you do not permanently reside in Florida, file with the Supervisor of the county where your agency has its headquarters.) Form 1 filers who file with the Supervisor of Elections CPA or ATTORNEY SIGNATURE ONLY If a certified public accountant licensed under Chapter 473, or attorney in good standing with the Florida Bar prepared this form for you, he or she must complete the following statement: I, , prepared the CE Form 1 in accordance with Section 112.3145, Florida Statutes, and the instructions to the form. Upon my reasonable knowledge and belief, the disclosure herein is true and correct. CPA/Attorney Signature Date Signed FILING INSTRUCTIONS: may file by mail or email. Contact your Supervisor of Elections for the mailing address or email address to use. Do not email your form to the Commission on Ethics, it will be returned. State officers or specified state employees who file with the Commission on Ethics may file by mail or email. To file by mail, send the completed form to P.O. Drawer 15709, Tallahassee, FL 32317-5709; physical address: 325 John Knox Rd, Bldg E, Ste 200, Tallahassee, FL 32303. To file with the Commission by email, scan your completed form and any attachments as a pdf (do not use any other format), send it to CEForml@leg.state.fl.us and retain a copy for your records. Do not file by both mail and email. Choose only one filing method. To determine what category your position falls under, see the "Who Must File" Instructions on page 3. NOTE: If you are leaving office or employment during the first half of 2021, you may not have filed Form 1 for 2020. In that case, this is not the last form you will file. Form 1F covers January 1, 2021, through your last day of office or employment. You will be required to file Form 1 for 2020 by July 1, 2021, and risk being fined if you do not file Form 1 by the filing deadline, even if you have already filed the CE Form 1 F. CE Form 1F Effective: January 1, 2021 HAUL 2 Incorporated by reference in Rule 34-8.208(2), F.A.C. Table 1 PART C -REAL PROPERTY 1285 Sharrow Way Carson City, NV 89703 PART D INTANGIBLE PERSONAL PROPERTY Saving Account (Suntrust) 401 K Retirement Account (Mass Mutual IRA- Retirement Account (Fidelity) Money Market Account (Sabadell Bank) Bank Account (Marquis Bank) IRA- Retirement Account (Raymond James) 0000001