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OATH 9/6/2001 _ ,....,.r--o.\ '~\\ ',.- l:'~ ~ ':1 C ~) C i SC'J -':J f'l\ \2: \ l; LOYALTY OATH _.,CANDIDATES WlTH NO PARTY AFFILIATION ,',; "r i' i~" i~ (Sec:ions 876.05-<176.10, F'a'<la SlaMes) STATE OF FLORIDA Miami-Dade COUNTY I, I (~SE Pi'UHTJ SCl.U\ K.. GRoss Finrt Name Middle Name/1nttial 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 Cons'Jtution of the United States and of the State of Fiorida, OATH OF CANDIDATE (Sec:ia1 99,021, F'a'<la Stautes) I, 5o..\l \ (,. ('0$$ (Pt..E.ASl! PRINT N.AME AS YOU 'MSH IT TO APPUR ON THE 8ALl..OT _ N.IMe MAY HOT BE 04AHGE.D AFTER Tl-lI! END OF QUAUfY1NG1 am a candidate for the office of l i-\"~ Lo k1 ~ LS)[9<1 (oflIce) . I am a qualified elector of Miami-Oade 2- NlA N1A (dlslr1ct) (clf1:utt) County. Florida, (grouP) I 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. UNDER PENALTIES OF PERJURY, I DECLARE THAT I HAVE READ THE FOREGOING LOYALTY OATH AND OATH OF CANDIDATE AND THAT THE FACTS STATED IN EACH ARE TRUE. SIGN :HER.E Sa.JZ K. if~ SlglUllUf'O al C."dl~ ?-~oo Mailing Address f2IUWlI 10 t(l~ ('30.>) 5)1-T}bt Cay Phone (7\))) S)2-D~17 Fu Humber iI1\~ ~ City FloV"lL. Sl3tII '33/'10 Zip COde ~~Ol Dote SI OS-OE 24B (Rev. 8/99) FORM 1 STATEMENT OF FINANCIAL INTERESTS 2000 :" ~:: ;'. -: ~ \ ",~ LAST NAME FiRST NAME MIDDLE NAME: Gross - Saul - K NAME OF REPORTING P~RSON'S AGENCY: ". Ci ty of MiamF Beach <: c"" -' I ; ,'.:: !!~ M~UNG ADDRESS: 2900 Flamingo Drive CITY: Miami Beach ZIP: 33140 COUNTY: Dade CHECK ~ OF THE FOLLOWING (see'Who Must Fil~' on page 3): o LOCAL OFFICER 0 STATE OFFICER fj; CANDIDATE 0 SPECIFIED STATE EMPLOYEE LIST OFFICE OR POSITION HELD OR SOUGH'!: City Commissioner Group 2 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 (cheel< one): :J(. 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 (cheel< one): ~ 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 OF INCOME ADDRESS Streamline Pro erties I"ashinaton Center Limit Partnership 1125 Washington Avenue d 1121-1151 Washington Ave t ree DESCRIPTION OF THE SOURCE'S PRINCIPAL BUSINESS ACTIVITY Real Estate Owner of retail stores Owner of retail stores r,rand Trine Limited Partnership 915-943 Washington Avenue 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 Streamline Properties emni South Beach, L.P. e O\'Ii1er of Office Buildi 'as g n n e I Retail store Neno, nc. Retail store Restaurant Retail store PART C - REAL PROPERTY [Land, buildings owned by the reporting person] FILING INSTRUCTIONS for when and where to file this form are located at the bottom of page 2. stores 1121-1151 ,'lashington Avenue, 226-234 12th Street, Miami Beach 915-943 Washington Avenue, Miami Beach, Florida - stores INSTRUCTIONS on who must file this form and how to fill it out begin on page 3 of this packet. OTHER FORMS you may need to file are described on page 6. CE FORM 1 - Eft. 1/2001 (Continued on reverse side) PAGE 1 PART D - INTANGIBLE PERSONAL PROPERTY [Sloel<s, bonds, certificates of deposit, etc.] TYPE OF INTANGIBLE B'~'~;N"~~~ ENTITY TO WHIr.H TH~ PROPERTY RELATES InvestIrent Account Paine-~\lebber , Inc. Invest:rrent Account National Financial Services, LIJ: Invest:rrent Account E-Trade Se=ities, Inc. Partnership Interest Washington Center Limited Partnership Partnership Interest Grand Trine Limited Partnership Stock Streamline Properties, Inc. PART E - LIABILITIES [Major debts] NAME OF CREDITOR ADDRESS OF CREDITOR Colonial Bank 901 Arthur Godfrey Ibad, Miami Beach, FL 33140 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 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 Cl SIGNATURE: 5Lt~ K. ~/ DATE SIGNED: q/S-;O[ 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 to confirmation, even if that is less than 30 Elections of the county in which you permanently days from the date of their appointment. reside. (If you do not permanently reside in NOTE: MULTIPLE FILING UNNECES- Florida, file with the Supervisor of the county Candidates for publicty-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 1 st 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 each local officer, state officer, and specified falls under, see the 'Who Must File" Instructions 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