OATH 9/4/01
i~D LOYALTY OATH
,;! S""' -c ': I,' c:; .cANDIDATES WITH NO PARTY AFFILIATION
.- ! I" ' . "b (S<Cticns 876.05.a76.10, FktiCa Statutes)
., ".'.',' ;:-'~ ~ ... r-
STATE OF'FLORJDA' [~i: Miami-Dade
COUNTY
(PLEASE PRINT)
I, I
JOSE
SMITH
FIrst Name
"kid~ Ham4/1nitial
Last Name
a citizen of the State of Florida and of the United States of America, . .. and a candidate for public office. .. do
hereby solemnly swear or affirm that I will support the Constitution of the United States and of the State of Florida_
OATH OF CANDIDATE
(Sedcn 99.021, FktiCa Statutes)
I,
.JOSE SMITH
(Pt..EASE PRINT NAME AS YOU 'MSH IT TO APPEAR Ct\I THE BAU.OT _ KAME tu.Y NOT BE QWroIGED AFTER THE END a= QUAUFY1NG)
I . I am a qualified elector of
(group) _
1 am a qualified elector of the City of Miami Beach, Florida. I am qualified under the ordinances and Charter
of said City and under the Constitution and the Laws of Florida to hold the office to which I desire to be
nominated or elected. I have qualified for no other public office in the state, the term of which office or any
part thereof runs concurrent with the office I seek; and I have resigned from any office from which I am
required to resign pursuant to Section 99.012, Florida Statutes.
City Commissioner.
(offtce)
Miami-Dade
NJA
NJA
(clr<:ult)
am a candidate for the office of Miami Beach
(dlstr1ct)
County, Florida.
UNDER PENALTIES OF PERJURY. I DECLARE THAT 1 HAVE READ THE FOREGOING LOYALTY OATH AND OATH OF
CANDIDATE AND THAT THE FACTS STATED IN EACH ARE TRUE.
SIGN
:H:ER.E
887 No. Shore Drive
Mailing Addl9SS
( 305 ) 792-0060
Cay Phone
( 305) 792-00~1
Fax Number
City
StI18
Zip Code
Miami Beach, FL 33140
OS-DE :z.4B (Rev. llI1l9)
FORM 1 STATEMENT OF 2000
FINANCIAL INTERESTS :1' .-
;.t:'(1~~""1
LAST NAME FIRST NAME MIDDLE NAME: NAME OF REPORTING PE~~'~ AGENCY: ....'
, . ~ -'
. I ..,f..- rJ ,
SMITH, JOSE JOSE SMITH .. . ....;, p, f. ~
. . ; ./ '. .1
MAILING ADDRESS: .... '5
v
887 North Shore Drive CHECK QtIE OF THE FOLLOWlNG(see~o.~~ f.ile' on page 3):
"-.( I Ii-l.^
!!f LOCAL OFFICER 0 -....
STATE OFFICER
0 CANDIDATE 0 SPECIFIED STATE EMPLOYEE
CITY: ZIP: COUNTY: LIST OFFICE OR POSITION HELD OR SOUGHT:
Miami Beach. 33141-0000 Miami-Dade
Miami Beach Citv Commission
DISCLOSURE PERIOD:
THIS STATEMENT REFLECTS YOUR FINANCIAL INTERESTS FOR THE PRECEDING TAX YEAR, WHETHER BASED ON A CALENDAR YEAR OR ON
A FISCAL YEAR. PLEASE STATE BELOW WHETHER THIS STATEMENT IS FOR THE PRECEDING TAX YEAR ENDING EITHER (check one):
~ DECEMBER 31, 2000 QB 0 SPECIFY TAX YEAR IF OTHER THAN THE CALENDAR YEAR:
MANNER OF CALCULATING REPORTABLE INTERESTS:
PRIOR TO 2001, THE THRESHOLDS FOR REPORTING FINANCIAL INTERESTS WERE COMPARATIVE, USUALLY BASED ON PERCENTAGE VAL-
UES. BEGINNING IN 2001, THE LEGISLATURE HAS ALLOWED FILERS THE OPTION OF USING REPORTING THRESHOLDS THAT ARE ABSOLUTE
DOLLAR VALUES, WHICH REQUIRES FEWER CALCULATIONS (see instructions for further details). PLEASE STATE BELOW WHETHER THIS STATE-
MENT REFLECTS EITHER (check one):
lW COMPARATIVE (PERCENTAGE) THRESHOLDS (old method) QB 0 DOLLAR VALUE THRESHOLDS (new method)
PART A -- PRIMARY SOURCES OF INCOME [Major sources of income to the reporting person]
NAME OF SOURCE SOURCE'S DESCRIPTION OF THE SOURCE'S
OF INCOME ADDRESS PRINCIPAL BUSINESS ACTIVITY
Smith & Supraski, P.A. ~~JV ".c. UL-., L,.llU .r Law Office
North Miami Beach, FL 33180
Bay Title Company &~f~hNMtam~i~~~cK~r~fn~3r80' 2nd F Title Insurance
S & S Equities, Inc. ;1.450 N...J;:. l:Iiami Gar~~~, 2nd F 1/p"l F.~" '-'f'
1ces
Bav Harbour Professional Ctr. Bi~uH~~g~u~~nr~u~~i54 Office Building
Greynolds Park Village Shoppe ~b~~g Miagix~~a~gh~tY33160 Shopping Center
'.
PART B - SECONDARY SOURCES OF INCOME (Major customers, clients, and other sources of income to businesses owned by the reporting person]
NAME OF NAME OF MAJOR SOURCES ADDRESS PRINCIPAL BUSINESS
BUSINESS ENTITY OF BUSINESS'S INCOME OF SOURCE ACTIVITY OF SOURCE
Pru-Shel Development Pt . I!Q~Ol Collins..,~venue l1>co' ID"<''''Q~
Union Planters Bank 16g~~ll'a~fiieg~ ~fo~3B~a Banking
Towers of Quayside HOA ~o9uA1a~~ulFLa~1138 Condominium Ass'n
PART C - REAL PROPERTY [Land, buildings owned by the reporting person] FILING INSTRUCTIONS for
yr;6XHotJdsnf~f~ ZH~~!!e. SRg~PH~a~~hfig~~R~ ~fn53I~0 when and where to file this form are
located at the bottom of page 2.
Office Building, 2450 N.E. Miami Gardens Drive INSTRUCTIONS on who must file
No. Miami Beach, FL 331/lU this form and how to fill it out begin
on page 3 of this packet.
I Don ;~' ~~1<b. OTHER FORMS you may need to
file are described on page 6.
CE FORM 1 - Elf. 1/2001
(Continued on reverse side)
PAGE 1
PART D -INTANGIBLE PERSONAL PROPERTY [Stocl<s, bonds, certiflClltes of depos~, etc.]
TYPE OF INl:A..,.,'c, " RI''''N''''''''NTITY Tn ""'I ''''''AT''''
Stocks, Bonds, Securities Prudential Securities/First Union/State of Israel
Stock Smith & Supraski, P.A.
Stock Bav Title Comnanv
Stock S & S Equities, Inc.
PART E - LIABILITIES [Major debts]
NAME OF CREDITOR ADDRESS OF CREDITOR
N/A
PART F - INTERESTS IN SPECIFIED BUSINESSES [OWnership or positions in certain types of businesses]
BUSINESS ENTITY # 1 BUSINESS ENTITY # 2 BUSINESS ENTITY # 3
NAME OF N/A
BUSINESS ENTITY
ADDRESS 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
IF ANY OF PARTS A THROUGH F ARE CONTINUED ON A SEPARATE SHEET, PLEASE CHECK HERE [J
SIGNATU~ ), j/., DATE SIGNED: CJ / Y {19 I
/~/n
, FILING INSTRUCTIONS:
WHAT TO FILE: WHERE TO FILE: WHEN TO FILE:
After completing all parts of this form, including If you were mailed the form by the Commission Initially, each local officer, state officer, and
signing and dating it, send back only the first on Ethics or a County Supervisor of Elections for specified state employee must file within 30
sheet (pages 1 and 2) for filing. your annual disclosure filing, return the form to days of the date of his or her appointment or of
that location. the beginning of employment. Appointees who
Local officers file with the Supervisor of must be confirmed by the Senate must file prior
Elections of the county in which you permanently to confirmation, even if that is less than 30
reside. (If you do not permanently reside in days from the date of their appointment.
NOTE: MULTIPLE FILING UNNECES- Florida, file with the Supervisor of the county Candidates for publicly-elected local office
SARY: where your agency has its headquarters.) must file at the same time they file their quali-
Generally, a person who has filed Form 1 for a State officers or specified state employees file lying papers.
calendar or fiscal year is not required to file a sec- with the Commission on Ethics, P.O. Drawer Thereafter, local officers, state officers, and
ond Form 1 for the same year. However, a candi- 15709, Tallahassee, FL 32317-5709. speCified state employees are required to file
date who previously filed Form 1 because of Candidates file this form together with your qual- by July 1st following each calendar year in
another public position must at least file a copy of which they hold their positions.
his or her original Form 1 when qualifying. ifying papers.
To determine what category your position Finally, at the end of office or employment
falls under, see the 'Who Must File" Instructions each local officer, state officer, and specified
state employee is required to file a final disclo-
on page 3. sure form (Form 1 F) within 60 days of leaving
office or employment.
CE FORM 1 - Elf. 1/2001
PAGE 2