Rafael Paz County Form QTR INAM!BEACH
O FFIC E O F TH E C ITY CL ERK
City of Miami Beach, 1700 Convention Center Drive, Miami Beach, FL 33139
www.miamibeachfl,goy
Telephone: 305.673-7 411
Ju n e 7, 20 2 2
M ia m i-D a d e C lerk of the
Bo ard of C o u nty C o m m issio n e rs
11 1 N W 1"S tre et , # 17 -10
M ia m i, F L 33 12 8
P u rsu a n t to Se ction 2-11 .1(e) 4) of the C ode of M iam i-Dade C ounty, attached please find a copy
o f th e M ia m i-D a d e C o u nty Q uart erly G ift D iscl o sure Form , fo r the quart er ending M arch 2022, fo r
th e fo llo w in g C ity of M ia m i Be ach Pe rso n ne l:
R afa el P a z - Ci ty A tt o rn e y (C ity of M ia m i Be a ch)
T h e o rig in a l ha s be e n file d w ith the M ia m i B e ach O ffi ce of the C ity C lerk.
S h ou ld yo u ha ve any qu e stio ns or re q uire any additional info rm ation, please contact m e at
3 0 5.67 3. 7 4 11 .
2
R a fael E. G ra n a d o,
C ity C lerk
A tt a chm en ts
R E G :c d
S e n t C ert ifi e d R eturn R ece ip t
MIAMI-DADE COUNTY
QUARTERLY GIFT DISCLOSURE
LAST NAME-FIRST NAME-MIDDLE NAME: NAME OF AGENCY:
Paz, Rafael A. City of Miami Beach
STREE ADDRESS: OFFICE OR POSITION HELD:
1700 Convention Center Drive, 4th Floor City Attorney
CITY: Miami Beach FOR QUARTER ENDING (Check One):
ZIP: 33130 MARCH □JUNE
COUNTY: Miami-Dade □SEPT. □DEC. YEAR: 2022
PART A: STATEMENT OF GIFTS. List below each gift, or series of gifts, from one person or entity in
excess of $10 0, 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
fil e 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
2 Passes - Boat Show $350.00 each City of Miami Beach, 1700 Convention Ctr. Dr. 02/10/2022 per ticket policy Miami Beach, FL 33139
CHECK HE RE IF CONTI NUED 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: 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 I 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
Countyr--a--
Signature of Person Making Gift Disclosure
STA TE OF FLORIDA
COUNTY OF _Miami-Dade
Sworn to (or affirmed) and subscribed before me this
7/\ day of _June 2022 ,
[,tn nfn.md n
(Print, Type, or Stamp Co
dz. )I Personally known to me
Type of Identification Produced:
os
985873
, 2024
erwrit ers
C O E 0 2/2 0 10
City Clerk USPS CERTIFIED MAIL
1111 11 111 I
9214 8901 9403 8378 8968 32
MIAMI-DADE CLERK OF THE BOARD OF COUNTY COMMISSIONERS
111 NW 1ST ST UN IT 17 -10
MIAMI FL 33128-1902
Fold Here
R eturn R eference N um b er:
U se m a m e : C h arle s D ag o stin
C o de V io latio n # :
C o u rt C ase #:
P ro p e rt y A dd ress : :
P e rm it ID #:
C usto m 5:
P o stag e : $6 .13 00