David V Suarez County QTR ICity of Miami Beach
City Clerk
1700 Convention Center Dr
Miami Beach Fl 33139
USPS CERTIFIED MAIL
I 11111111 II
9214 8901 9403 8367 8996 39
MIAMI-DADE CLERK OF THE BOARD OF COUNTY COMMISSIONERS
111 NW1STSTUNIT17-10
MIAMI FL 33128-1902
Fold Here
Return Reference Number:
Username: Keila Mena Caceres
Code Violation # :
Court Case #:
Property Address::
Permit ID#:
Custom 5:
Postage: $7.6000
M IA M I-D A D E C O U N T Y
Q U A R T E R L Y G IF T D IS C L O S U R E
LAST NAME-FIRST NAME-MIDDLE NAME: Cue Dd tor AME OF AGENCY: s /tie, eek
STREE ADDRE S:
n enter c. R POSITION HELD:
mmissioner- Go S
71: 33]
COUNTY:
FOR QUARTER ENDING (Check On'): Koc
□SEPT. □DEC. YEAR: 20
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 on 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
it t\ ti
rL. 924 • %),500 \,\ JI
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: 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.l (e)(4) of the Code of Miami-Dade
County.
star or Foy9},,- pol
COUNTY OF ,.ham)-, (
Sworn to (or affirmed) and subsc3.~ before me this )l oot Sue .o. .
» D u] l/do Saez-
(Na~gGiftrnsclosurc)
(Signature of Notary Public. State of Florida)
$e below
(Print, Type, or Stamp Commissioned Name of Notary Public)
fpsorally known to me or D Produced Identification re or Identification Produced:
COE02/2010
98,, BRANDON LLOYD
l~~~ Notary Public-State of Florida 3el lg Commission # HH 486884 %@»Ms!is iv commission xires
"iii" January 30, 2028