Monica Salinas County Form QTR IIIMIAMI BEACH
O FFIC E O F TH E C ITY C LERK
C ity of M iam i Beach, 17 0 0 C onvention C enter D rive, M iam i Beach, FL 33 13 9
www .m igm ibeacht]_gov
Telephon e: 30 5.6 7 3-7 4 11
D e cem b er 22, 2 0 2 3
M ia m i-D a d e C lerk of the
Bo a rd of C o u n ty C o m m issioners
11 1 N W 1Street, # 17 -10
M ia m i, F L 3 3 12 8
P u rsu a n t to S e ction 2-11 .1 ( e )( 4 ) of the C o de of M ia m i-D ade C ounty, attache d ple ase find a copy
o f th e M ia m i-D a d e C o u n ty Q u a rt e rly G ift D isclo su re Fo rm , fo r the quart e r end ing Septem ber
20 2 3 , fo r th e fo llo w in g C ity of M ia m i Be a ch P erso n n e l:
M o n ic a M a tt e o -S a lina s - C o mm issio n A id e (C ity of M ia m i Beach)
T h e o rig in al ha s be e n file d w ith the M ia m i B e a ch O ff ice of the C ity C lerk.
S h o u ld yo u ha v e an y qu e stions or req u ire an y additional inform ation , ple a se contact m e at
30 5 .6 7 3 . 7 4 11 .
R e sp e ctfully,
#,, R af a el E. Gr an a d o,
o cty Clerk
REG IS BARBOU
A tt a ch m e n ts
R E G :cd
S e n t C e rt ifi e d R etu rn R e ce ip t
M I A M I -D A D E C O U N T Y
Q U A R T E RL Y G I F T D I S C L O S U RE
LAST NAME-FIRST NAME-MIDDLE NAME:
z0-{dinar
AME OF AGENCY:
of ~
POSITION HELD:
$Ji A
CI TY· ji- w
z1: 3336
COUNTY:
FOR QUARTER ENDING (Check One):
D MARCH
J DEC.
D JUNE
YEAR: 20 23
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 Oil the form. You are not required to
file this statement for any calendar quarter during which you did not receive a reportable gift.
DATE
RECEIVED
DESCRIPTION
OF GIFT
MONETARY
VALUE
NAME OF PERSON ADDRESS OF PERSON
MAKING THE GIFT MAKING THE GIFT
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 Oil the receipt. CHECK HERE IF A RECEIPT IS ATTACHED TO THIS FORM. 0
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, IHI 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
County.
u
sienai a a aline Git Disclosure
STATE OF FL.ORJpM, -_ p)/)f
coUNTY or / tu JTtUl
2/ srer$3g""
~~::-::-'-::=~~---------'--' $
CO E 02/2010
(Print, Type, or Stamp Commissionc, ' Ime of Notary Public)
~sonally kno\\~ to me orâ–¡Produced Identification
Type of Identification Produced:
~
.-<;f~~ii<'.;-. CHARLES J. DAGOSTIN /·A:?;, MY COMMISSION# HH 165705
:., ,ii EXPIRES: December 14, 2025 +, «9: i$" Bonded Tru Notary Public Underwriters
Mp %¢
C it y C le r k USPS CERTIFIED MAIL
I 1111111 I
9214 8901 9403 8342 6730 63
MIAMI-DADE CLERK OF THE BOARD OF COUNTY COMMISSIONERS
111 NW 1ST ST UNIT 17-10
MIAMI FL 33128-1902
Fold Here
Return Reference Num ber:
Usern am e: Charles Dagostin
Code Violation # :
Court Case #:
Pro perty Address : :
Perm it ID #:
Custom 5:
Postage: $7 .1800