Kristen Rosen Gonzalez Form 9 QTR IIIM IA M I B EA C H
O FFIC E O F TH E C ITY C LERK
C ity of M ia m i Beach, 17 00 C onvention C enter D rive, M iam i Beach, FL 33 139
www .m iam ibeachtl ,go
Telepho ne: 3 05 . 673-7 411
December 28, 2023
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 2023, 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. 7 411.
Respectfu I ly,
• Rafael E. Granado,
City Clerk
REGIS BARBOU
Attachment
REG:cd
Sent Certified Return Receipt
Form 9 QUARTERLY GIFT DISCLOSURE
(GIFTS OVER $100)
LA ST NAM E -- FIRS T NAM E -- MIDDLE NAME NAME OF AGENCY:
Rosen Gonzalez Kristen Citv of Miami Beach
MAILING ADDRESS: OFFICE OR POSITION HELD:
1700 Convention Center Drive Commissioner
CITY: ZIP: COUNTY: FOR QUARTER ENDING (CHECK ONE): YEAR
Miami Beach 33139 Miami-Dade □MARCH JUNE SEPTEMBER DECEMBER 2023
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
07/08/2023 Two tickets to Miami New Amount Miami New Drama 1040 Lincoln Road
Drama Papa Cuatro exceeds $100 Miami Beach, FL 33139
□CHECK HERE IF CONTINUED ON SEPARATE SHEET
PART B - RECEIPT PROVIDED BY PERSON MAKING THE GIFT
If any receipt for a gift listed above was provided to you by the person making the gift, you are required to attach a copy of that receipt to this
form. You may attach an explanation of any differences between the information disclosed on this form and the information on the receipt.
□CHECK HERE IF A RECEIPT IS ATTACHED TO THIS FORM
PART C- OATH
I, the person whose name appears at the beginning of this form, do
depose on oath or affirmation and say that the information disclosed
STATE OF FLORIA) 'n -
COUNTY OF /Ul(t E
(or affirmed) and subscribed before me by means of
\rscenes op/29,299%%p Jp
o1 dayo /](@4tr2 ,2o_
(Print, Type, or Stamp SCommi
Personally Known _ O
Type of Identification Produce
PART D - FILING INSTRUCTIONS
:.5 gs ,
"$Fi%" Bonded Thru Notary Public Underwriters
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. 1/2016 (Re fer to Rule 34-7.010(1)g), F.A.C.) (See reverse side for instruction s) e
City Clerk USPS CERTIFIED MAIL
I I 1111111111
9214 8901 9403 8342 9789 60
FLORIDA COMMISSION ON ETHICS
PO BOX 15709
TALLAHASSEE FL 32317-5709
Fold Here
Return Reference Num ber:
Usern am e: Charles Dagostin
Code Violation # :
Court Case #:
Property Address : :
Perm it ID #:
Custom 5:
Postage: $7.1800