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Qualifying docs - P. Levine MIAMI BEACH City of Miami Beach, 1700 Convention Center Drive, Miami Beach?NWo 33139, www.miamibeachfi.gov CITY CLERK'S OFFICE Tel: 305-673-7411, Fax: 305-673-7254 Email: RafaelGranado @miamibeachfl.gov STATE OF FLORIDA COUNTY OF MIAMI-DADE Before me, an officer authorized to administer oaths, personally appeared to me well known who, being sworn, �ays that he/she is a candidate for the office of City Commissioner (Group No. (or M` ayo)for the City of Miami Beach, Florida; that he/she is a qualified ele or of said City residing within the City at least one year before qualifying for City of Miami Beach elected office; that his/her legal residence is: zxz r& *,, .'v{,G , Miami Beach, Miami-Dade County, Florida; that he/she is qualified under the ordinances (including Miami Beach City Code Chapter 38 qpve7ing "E ons") and Charter of said City to hold such office; and that he/she h pai a ire qualification fee. Philip Levine r Candidate ign a Candidate Sworn to and subscribed before me this 3� day of , 2013. Xj h�AQ2 i Authorized Officer Signature of Notary ARY SEAL rima.Bilf-IF N9 uuaM R.HATHEI D MY COMMISSION#EE 844865 Date EXPIRES:February 18,2017 Bonded Thru Notary Public Underwriters F:\CLER\CLER\000_ELECTION\0000_2013 General Election\MISCELLANEOS WORD DOCS\CANDIDATE'S OATH.Docx i CANDIDATE OATH — 2013 SEA' -3 PM 12: 09 NONPARTISAN OFFICE Y, (Not for use by Judicial or School Board Candidates) OFFICE USE ONLY OATH OF CANDIDATE (Section 99.021,Florida Statutes) I, Philip Levine (PLEASE PRINT NAME AS YOU WISH IT TO APPEAR ON THE BALLOT"- NAME MAY NOT BE CHANGED AFTER THE END OF QUALIFYING) am a candidate for the nonpartisan office of Mayor of Miami Beach n/a , (office) (district#) n/a n/a ; I am a qualified elector of Miami-Dade County, Florida; (circuit#) (group or seat#) I am qualified 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- nd I will support the Constitution of the United States and the Constitution of the State of Florida. X (305)673-9500 philip@levineformayor.com rNView ture of Candidate Telephone Number. Email Address 1 Drive Miami Beach FL 33140 Address City State ZIP Code Candidate's Florida Voter Registration Number(located on your voter information card): 109791988 * Please print name phonetically on the line below as you wish it to be pronounced on the audio ballot for persons with disabilities (see instructions on page 2 of this form): FILL-ip LE-veen STATE OF FLORIDA COUNTY OF Sworn to(or affirmed)and subscribed before me this 3 day of , 20 Personally Known: or Signature of Notary Public Produced Identification: ✓ Print,Type,or Stam Co i o lic ULM R.HATFIELD Type of Identification Produced:U,( Y� i,; MY COMMISSION#EE 84!t865 EXPES:February 18,2a 1!1- B=M hn!Notary Public LMd4iWfIW15 DS-DE 25(Rev.5111) Rule 1S-2.0001,F.A.C. FORM 1 STATEMENT OF 2012 Please print or type your name,mailing FINANCIAL INTERESTS address,agency name,and position below: 2� �R q FI A� ! LAST NAME--FIRST NAME--MIDDLE NAME: LEVINE, PHILIP LOUIS MAILING ADDRESS: 1425 NORTH VIEW DRIVE CITY: ZIP: COUNTY: MIAMI BEACH 33140 MIAMI-DADE �, r_a NAME OF AGENCY: CITY OF MIAMI BEACH ; NAME OF OFFICE OR POSITION HELD OR SOUGHT: r" MAYOR You are not limited to the space on the lines on this forth.Attach additional sheets,N necessary. CHECK ONLY IF ® CANDIDATE OR ❑ NEW EMPLOYEE OR APPOINTEE C, - r **** BOTH PARTS OF THIS SECTION MUST BE COMPLETED DISCLOSURE PERIOD: FT 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(must check one): ® DECEMBER 31, 2012 OR ❑ SPECIFY TAX YEAR IF OTHER THAN THE CALENDAR YEAR: MANNER OF CALCULATING REPORTABLE INTERESTS: THE LEGISLATURE ALLOWS FILERS THE OPTION OF USING REPORTING THRESHOLDS THAT ARE ABSOLUTE DOLLAR VALUES,WHICH REQUIRES FEWER CALCULATIONS,OR USING COMPARATIVE THRESHOLDS,WHICH ARE USUALLY BASED ON PERCENTAGE VALUES (see instructions for further details). CHECK THE ONE YOU ARE USING: ® COMPARATIVE(PERCENTAGE)THRESHOLDS OR ❑ DOLLAR VALUE THRESHOLDS PART A--PRIMARY SOURCES OF INCOME [Major sources of income to the reporting person-See instructions] (If you have nothing to report,you must write"none"or'Wa") NAME OF SOURCE SOURCE'S DESCRIPTION OF THE SOURCE'S OF INCOME ADDRESS PRINCIPAL BUSINESS ACTIVITY Royal Media Partners, LLC 960 Alton Road, Miami Beach FL 33139 Media Co. Media Holdings, Ltd. 960 Alton Road, Miami Beach FL 33139 Rental Real Estate PART B-- SECONDARY SOURCES OF INCOME [Mayor customers,clients,and other sources of Income to businesses owned by the reporting person-See Instructions] (if you have nothing to report,write"none"or"nla") NAME OF NAME OF MAJOR SOURCES ADDRESS PRINCIPAL BUSINESS BUSINESS ENTITY OF BUSINESS'INCOME OF SOURCE ACTIVITY OF SOURCE. Royal Media Partners, LLC Almod Diamonds Ltd. 592 Fifth Ave, NY, NY 10036 Jewelry Sales Media Holdings, Ltd. Royal Media Partners, LLC 960 Alton Rd., MB, FL 33139 Media Co. Royal Media Partners, LLC Royal Caribbean Cruise Lines i1050 Caribbean Way, Miami, FL Cruise Line PART C--REAL PROPERTY [Land,buildings owned by the reporting person-See instructions] FILING INSTRUCTIONS for (If you have nothing to report,you must write"none"or"n/a") when and where to file this See attached list form are located at the bottom of page 2. INSTRUCTIONS on who must file this form and how to fill it out begin on page 3. CE FORM 1-Effective:January 1,2013.Refer to Rule 34-8.202(1),F.A.C. (Continued on reverse side) PAGE 1 PART D—INTANGIBLE PERSONAL PROPERTY[Stocks,bonds,certificates of deposit,etc.-See instructions] (If you have nothing to report,you must write"none"or"n/a") TYPE OF INTANGIBLE BUSINESS ENTITY TO WHICH THE PROPERTY RELATES See attached list PART E—LIABILITIES [Major debts-See instructions] (If you have nothing to report,you must write"none"or"n/a") NAME OF CREDITOR ADDRESS OF CREDITOR N/A PART F—INTERESTS IN SPECIFIED BUSINESSES [Ownership or positions in certain types of businesses-See instructions] (If you have nothing to report,you must write"none"or"n/a") BUSINESS ENTITY#1 BUSINESS ENTITY#2 BUSINESS ENTITY#3 NAME OF BUSINESS ENTITY N/A 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 THRQ0dA F ARE CONTINUED ON A SEPARATE SHEET PLEASE CHECK HERE 63 SIGNATUR : DATE S NED re uired : FILING INSTRU `TI NS: W TO FILE: WHERE TO FILE: WHEN TO FILE: A r completing all parts of this form, If you were mailed the form by the Commission Initially, each local officer/employee, including signing and dating it,send back on Ethics or a County Supervisor of Elections state officer, and specified state employee only the first sheet(pages 1 and 2)for filing. for your annual disclosure filing, return the must file within 30 days of the date of form to that location. his or her appointment or of the beginning If you have nothing to report in a particular Local officers/employees file with the of employment. Appointees who must be section,you must write"none"or'n/a"in that Supervisor of Elections of the county in confirmed by the Senate must file prior to section(s). which they permanently reside. (If you do not confirmation, even if that is less than 30 permanently reside in Florida, file with the days from the date of their appointment. NOTE: Supervisor of the county where your agency Candidates for publicly-elected local office MULTIPLE FILING UNNECESSARY: has its headquarters.) must file at the same time they file their Generally, a person who has filed Form 1 State officers or specked state employees qualifying papers. for a calendar or fiscal year is not required file with the Commission on Ethics, P.O. Thereafter, local officers/employees, state to file a second Form 1 for the same year. Drawer 15709,Tallahassee, FL 32317-5709. officers, and specified state employees However, a candidate who previously filed Candidates file this form together with their are required to file by July 1st following Form 1 because of another public position each calendar year in which they hold their must at least file a copy of his or her original qualifying papers. positions. Form 1 when qualifying. To determine what category your position falls Finally, at the end of office or employment, under,see the"Who Must File"Instructions on each local officer/employee,state officer,and page 3. specified state employee is required to file a final disclosure form(Form 1 F)within 60 days Facsimiles will not be accepted. of leaving office or employment. However, filing a CE Form 1 F (Final Statement of Financial Interests) does not relieve the filer of filing a CE Form 1 if he or she was in their position on December 31,2012. CE FORM 1-Effective:January 1,2013.Refer to Rule 34-8.202(1),F.A.C. PAGE 2 FORM 1 - STATEMENT OF FINANCIAL INTERESTS LEVINE, PHILIP LOUIS PART C -- REAL PROPERTY LOCATION 1 DESCRIPTION "'S': e• P 1425 N. View Drive, Miami Beach, FL 33140 1930 Bay Road, Miami Beach, FL 33139 1919 Purdy Avenue, Miami Beach, FL 33139 1929 Purdy Avenue, Miami Beach, FL 33139 100017th Street, Miami Beach, FL 33138 1900 Bay Road, Miami Beach, FL 33139 1916 Bay Road, Miami Beach, FL 33139 1787 Purdy Avenue, Miami Beach, FL 33139 1935 West Avenue, Miami Beach, FL 33139 960 Alton Road, Miami Beach, FL 33139 930 Alton Road, Miami Beach, FL 33139 2237 NW 1 Place, Miami, FL 33127 2200 NW 1 Place, Miami, FL 33127 2215 NW 1 Place, Miami, FL 33127 175 NW 22 Street, Miami, FL 33127 170 NW 23 Street, Miami, FL 33127 63 NW 27 Street, Miami, FL 33127 65 NW 27 Street, Miami, FL 33127 49 NW 27 Street, Miami, FL 33127 35 NW 27 Street, Miami, FL 33127 255 Glenridge Road, Key Biscayne, FL 33149 2520 Shelter Avenue, Miami Beach, FL 1525 W 21st St, Miami Beach, FL 33140 1800 West 27th, Miami Beach, FL 33139 9400 NE 120th St, Okeechobee, FL 34972 2121 HWY 70 W, Okeechobee, FL 34972 2229 HWY 70 W, Okeechobee, FL 34972 1900 Sunset Harbour Drive P216, Miami Beach, FL 33139 1900 Sunset Harbour Drive P217, Miami Beach, FL 33139 1900 Sunset Harbour Drive P218, Miami Beach, FL 33139 1900 Sunset Harbour Drive P219, Miami Beach, FL 33139 Although it is not required to disclose the following, in the interest of full candor, we would like to make known that Scott Robins Companies (SRC), located at 230 5th Street, Miami Beach, FL 33139, is a business partner in the following real estate investments: o 1930 Bay Road, Miami Beach, FL 33139 o 1919 Purdy Avenue, Miami Beach, FL 33139 o 1929 Purdy Avenue, Miami Beach, FL 33139 C-7) 0 100017th Street, Miami Beach, FL 33138 COO ' o 1900 Bay Road, Miami Beach, FL 33139 0 - o 1916 Bay Road, Miami Beach, FL 33139 u- 0 1787 Purdy Avenue, Miami Beach, FL 33139 o 1935 West Avenue, Miami Beach, FL 33139 CD o 960 Alton Road, Miami Beach, FL 33139 o 930 Alton Road, Miami Beach, FL 33139 o 1900 Sunset Harbour Drive P216, Miami Beach, FL 33139 o 1900 Sunset Harbour Drive P217, Miami Beach, FL 33139 o. 1900 Sunset Harbour Drive P218, Miami Beach, FL 33139 o 1900 Sunset Harbour Drive P219, Miami Beach, FL 33139 FORM 1 - STATEMENT OF FINANCIAL INTERESTS LEVINE, PHILIP LOUIS PART ® -- INTANGIBLE PERSONAL PROPERTY TYPE OF INTANGIBLE BUSINESS ENTITY TO WHICH THE PROPERTY RELATES Cash Held by Goldman Sachs & Co. Interest in Partnership Royal Media Partners, LLC Interest in Partnership Bay Road Partners, LLC Stock Royal Caribbean Cruises Ltd. ry .y �l Form 9 QUARTERLY GIFT DISCLOSURE (GIFTS OVER $100) LAST NAME--FIRST NAME--MIDDLE NAME: NAME OF AGENCY: ; J LEVINE, PHILIP LOUIS City of Miami Beach r_' MAILING ADDRESS: OFFICE OR POSITION HELD: -x- 1425 North View Drive Mayor ' CITY: ZIP: COUNTY: FOR QUARTER ENDING (CHECK ONE): c; YEAfi Miami Beach FL Miami-Dade ❑MARCH OJUNE ❑SEPTEMBER ❑D'ECEMBER 20 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 NONE ❑ 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 STATE OF FLORIDA , COUNTY OF_j AfJI —h AcIOL, depose on oath or affirmation and say that the information disclosed Sworn to(or affirmed)ands bsc_ribed efore me this day of t'.rn f 20 herein and on any attachments made by me constitutes a true accurate, by of e-✓I plc, and total listing of all gifts ire o-be reported by Section 112.3148, ' Florida Statutes. (Signature Notary Public-State of Flo \)\`,01111i1111y���� (Print,Type,or Stamp Commissioned Name of of PL{ 0 S%;y• ��� SIGN F PORTING OFFICIAL Personally Known OR Produced Identific dh;• PPr1292o�f•:.�% Type of Identification Produced .z a DOg PART D— FILING INSTRUCTIONS A�/•eOob aeo fhru 5 e; Q`\ /, C •••ee•s••"q �� This form,when duly signed and notarized,must be filed with the Commission on Ethics,P.O.Drawer 15709,Tallahassee,Florida 3 41go.���u=` cal address:3600 Maclay Blvd.South,Suite 201,Tallahassee,Florida 32312.The form must be filed no later than the last day of the calenyjflo'"arter 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. 1/2007 (See reverse side for instructions)�"