Qualifying DocumentsCANDIDATE OATH —
NONPARTISAN OFFICE
(Not for use by Judicial or
School Board Candidates)
IECEIVED
7OH SEP -6 AM 9: 2t
QIT Y OF MI Am TrAcH
FF)CE Ci TY oF THE CLERK
OFFICE USE ONLY
OATH OF CANDIDATE
(Section 99.021, Florida Statutes)
I , ik4 le-V-1
S 7elA036 e.6-
(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 1.1,/kisAk a 6/ke...1-t Comm, ss) 0/4eve , NIA
(office)
(district #)
N/A , I ; I am a qualified elector of MI A-m.t -.0/4-0 r County, Florida;
(circuit #) (group or seat #)
I am a qualified elector of the City of Miami Beach, Florida, residing within the City at least one year before qualifying for City of Miami Beach
elected office, with my legal residence being: le, emi or . # semi , MS Ft- 33141i , 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; and I will support the Constitution of
the United States and the Constitution of the State of Florida.
yi, - - - - - 1 !lo - tri i - ,-/0 .4 mi,..1.1 9
pALAA Piz-010. avkA
X Signature of Candidate Telephone Number Email Address
goo $A-4i j>2... It gbq Ail t AMI
6CA (--1-4 FL 311(11
Address City State ZIP Code
Candidate's Florida Voter Registration Number (located on your voter information card): / 102- 3 PC 15—
* 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):
MIK-et ,-retni --loutir_S
STATE OF FLORIDA
COUNTY OF AAIA.M1- bAte_-
Sworn to (or affirmed) and subscribed before me this 6 day of Se-Pl-covqbeiL. , 20 1 —7 .
Personally Known: 17 or
Sign
Produced Identification: Print,
a of Notary Public
.- . , C. imiss oned Name of Notar ....
_ , ..._ . .. . Public
Type of Identification Produced: PeljoemA,/,‘,.. Nov*/ ". JASON SALVATORE
41:
t 1.61 MY COMMISSION # OG030527
sri ' - ,.7. EXPIRES: September '14,
2020 , r, T‘, Bonded That Notary Public Undenoltens
DS-DE 25 (Rev. 5/11)
Rule 1S-2.0001, F.A.C.
CANDIDATE OATH —
NONPARTISAN OFFICE
(Not for use by Judicial or
School Board Candidates)
CM R. ED
2011 SEP —6 Pit4 9; 24
CITY OF MIAMI I3EACH
OFFICE OF THE: CITY CLERK
OFFICE USE ONLY
OATH OF CANDIDATE
(Section 99,021, Florida Statutes)
I, Micky Steinberg
(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 Miami Beach Commissioner , N/A ,
(office) (district #)
N/A , 1 ; 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; and I will support the Constitution of the United States and the Constitution of the
State of Florida.
X ,,,, .---- (786)471-4304 micky@palmprop.com
Sigriature of Candidate Telephone Number Email Address
900 Bay Drive #504 Miami Beach Florida 33141
Address City State ZIP Code
Candidate's Florida Voter Registration Number (located on your voter information
card): 110231576
* 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):
MIK-ee STEIN-buhrg
STATE OF FLORIDA
COUNTY OF „dtejtafl-DE,_
Sworn to (or affirmed) and subscribed before me this
Personally Known: V— or
, day of
S 4-0.1-6,46672. , 20 1' 7 .
/
(J ,i.
Sign e of Notary Public
Produced Identification: Print, Type, or St- u • • •• •• '. --,i- •tary Public _
40.4, JASON SALVATORE
Type of Identification Produced: 1164-SONAilAii know"
IT * la MY COMMISSION # OG 030527
:moo'., " '41) EXPIRES: September 14, 2020
,,„„, ,cto' Bonded Thru Notary Pubile Underwriters
DS-DE 25 (Rev. 5/11)
Rule 1S-2.0001, F.A.C.
LIVED
2aI7SEP —6 iv; 9:24
CITY OF MIAMI BEACH OATH/AFFMIIMATM
EArii
OFFICE OF THE CITY CI:EfiK
MIAMIB0 CH
STATE OF FLORIDA
COUNTY OF MIAMI-DADE
Before me, an officer authorized to administer oaths, personally appeared Mk., ...5-7-6w66-
to me well known who, being sworn, says that he/she is a
candidate for the office of City Commissioner (Group No. ) or Mayor for the City
of Miami Beach, Florida; that he/she is a qualified elector 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: q Ob
At! Pa- 4 sin Ft. 33141
Miami Beach, Miami-Dade County, Florida; that he/she is qualified under the ordinances
(including Miami Beach City Code Chapter 38 governing "Elections") and Charter of said City to
hold such office; and that he/she has paid the required qualification fee or filed with the City
Clerk a petition approving his/her candidacy signed by sufficient qualified and registered voters
to constitute not less than two percent (2%) of this number of such voters as the same shall be
on the date sixty (60) days prior to the first day of qualifying as a candidate for office.
Sign 7 tur of Candidate
Sworn to (or affirmed) and subscribed before me this 6 day of Seirr6A46b 2
20n,
by
c ' 1 icxy STKAuJiJeg--e,
Sig.rture of Notary Public-State of Florida
44rIol.)
Name of Notary Typed, Printed or Stamped
(NOTARY SEAL)
ettritl;
,,
JASON SALVATORE
o•
I.41 MY COMMISSION # GG 030527 •
EXPIRES: September 14, 2020
Banded Thru Notary Public Underwriters
Personally Known OR Produced Identification
Type of Identification Produced PeA5o.v02-t-1/4, k_Arow,J
FACLER\CLER\000_ELECTION\000_2017 GENERAL ELECTION\FORMS\CITY OF MIAMI BEACH OATH AFFIRMATION last
updated 01242017.docx
SISIMIONIMISIIMMOk 41•111,611.111=Mq
FORM 1 STATEMENT OF 2016
Please print or type your name, mailing
address, agency name, and position below:
FINANCIAL INTERESTS FOR OFFICE USE ONLY:
LAST NAME -- FIRST NAME -- MIDDLE NAME :
Steinberg, Micky
MAILING ADDRESS :
900 Bay Drive #504
ri 1-11
C;' ) :ar 1
CITY : ZIP : COUNTY :
Miami Beach 33141 Miami-Dade
CIN riii
4‹
NAME OF AGENCY :
City of Miami Beach rn
NAME OF OFFICE OR POSITION HELD OR SOUGHT :
Commissioner
rn
You are not limited to the space on the lines on this form. Attach additional sheets, if necessary.
CHECK ONLY IF lir CANDIDATE OR u NEW EMPLOYEE OR APPOINTEE
**** BOTH PARTS OF THIS SECTION MUST BE COMPLETED ****
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 (must check one):
DECEMBER 31, 2016 Ql3 ID SPECIFY TAX YEAR IF OTHER THAN THE CALENDAR YEAR:
MANNER OF CALCULATING REPORTABLE INTERESTS:
FILERS HAVE THE OPTION OF USING REPORTING THRESHOLDS THATARE 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 (must check one):
;I COMPARATIVE (PERCENTAGE) THRESHOLDS OR li DOLLAR VALUE THRESHOLDS
PART A -- PRIMARY SOURCES OF INCOME
(If you have nothing to report,
NAME OF SOURCE
OF INCOME
[Major sources of income to the reporting person - See instructions]
write "none" or "n/a")
SOURCE'S
ADDRESS
DESCRIPTION OF THE SOURCE'S
PRINCIPAL BUSINESS ACTIVITY
Palm Properties of South FL, Inc 767 Arthur Godfrey Road, MB, FL 33140 Real Estate Company
City of Miami Beach 1700 Convention Center Dr., MB, FL 33139 Municipality
PART B — SECONDARY SOURCES
[Major customers, clients,
(If you have nothing to
NAME OF
BUSINESS ENTITY
A
OF INCOME
and other sources of income to businesses
report, write "none" or "n/a")
NAME OF MAJOR SOURCES
OF BUSINESS' INCOME
owned by the reporting person - See
ADDRESS
OF SOURCE
instructions]
PRINCIPAL BUSINESS
ACTIVITY OF SOURCE
N/A
I
PART C -- REAL PROPERTY [Land, buildings owned by the reporting person - See instructions]
(If you have nothing to report, write "none" or "n/a") FILING INSTRUCTIONS for when
and where to file this form are
INSTRUCTIONS on who must file
this form and how to fill it out
begin on page 3.
located at the bottom of page 2.
900 Bay Drive #504, Miami Beach, FL 33141
CE FORM 1 - Effective: January 1, 2017
Incorporated by reference In Rule 34-8,202(1), F.A.C.
(Continued on reverse side) PAGE 1
SIGNATURE OF FILER:
Signature:
Date Signed:
q-6-2,01q-
PART D — INTANGIBLE PERSONAL PROPERTY (Stocks, bonds, certificates of deposit, etc. - See instructions]
(If you have nothing to report, write "none" or "n/a")
TYPE OF INTANGIBLE
BUSINESS ENTITY TO WHICH THE PROPERTY RELATES
Charles Schwab SEP-IRA
Bank of America Bank Accounts
k
PART E — LIABILITIES [Major debts - See instructions]
(If you have nothing to report, write "none" or "n/a")
NAME OF CREDITOR ADDRESS OF CREDITOR
Chase (Home Mortgage) P.O. Box 78420, Phoenix, AZ 85062-8420
PART F — INTERESTS IN SPECIFIED BUSINESSES Ownership or positions in certain types of businesses - See instructions]
(If you have nothing to report, write "none" or "n/a") BUSINESS ENTITY # 1
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
PART G — TRAINING
For elected municipal officers required to complete annual ethics training pursuant to section 112.3142, F.S.
M/ I CERTIFY THAT I HAVE COMPLETED THE REQUIRED TRAINING.
IF ANY OF PARTS A THROUGH G ARE CONTINUED ON A SEPARATE SHEET, PLEASE CHECK HERE CI
N/A
BUSINESS ENTITY # 2
CPA or ATTORNEY SIGNATURE ONLY
If a certified public accountant licensed under Chapter 473, or attorney
in good standing with the Florida Bar prepared this form for you, he or
she must complete the following statement:
, prepared the CE
Form 1 In accordance with Section 112.3145, Florida Statutes, and the
instructions to the form. Upon my reasonable knowledge and belief, the
disclosure herein is true and correct.
CPA/Attorney Signature:
Date Signed:
WHAT TO FILE:
After completing all parts of this form, including
skirling and datina it, send back only the first
sheet (pages 1 and 2) for filing.
If you have nothing to report in a particular
section, write "none" or "n/a" in that section(s).
NOTE:
MULTIPLE FILING UNNECESSARY:
A candidate who files a Form 1 with a qualifying
officer is not required to file with the Commission
or Supervisor of Elections.
Facsimiles will not be accepted.
FILING INSTRUCTIONS:
WHERE TO FILE:
If you were mailed the form by the Commission
on Ethics or a County Supervisor of Elections for
your annual disclosure filing, return the form to
that location.
Local officers/employees file with the
Supervisor of Elections of the county in which they
permanently reside. (If you do not permanently
reside in Florida, file with the Supervisor of the
county where your agency has its headquarters.)
State officers or specified state employees
file with the Commission on Ethics, P.O. Drawer
15709, Tallahassee, FL 32317-5709; physical
address: 325 John Knox Road, Building E, Suite
200, Tallahassee, FL 32303.
Candidates file this form together with their
qualifying papers.
To determine what category your position falls
under, see page 3 of instructions.
WHEN TO FILE:
Initially, each local officer/employee, state officer,
and specified state employee must file within
30 days of the date of his or her appointment
or of the beginning of employment. Appointees
who must be confirmed by the Senate must file
prior to confirmation, even if that is less than
30 days from the date of their appointment.
Candidates must file at the same time they file
their qualifying papers.
Thereafter, file by July 1 following each calendar
year in which they hold their positions.
Finally, file a final disclosure form (Form 1F)
within 60 days of leaving office or employment.
Filing a CE Form 1F (Final Statement of Financial
Interests) does no relieve the filer of filing a CE
Form 1 if the filer was in his or her position on
December 31, 2016.
CE FORM 1 - Effective: January 1, 2017.
Incorporated by reference In Rule 34-8.202(1), FA,C,
PAGE 2
R ^ VED
AM 9:32
Form 9
QUARTERLY GIFT DISCLOSURE
(GIFTS OVER $100)
LAST NAME -- FIRST NAME - MIDDLE NAME:
Steinberg, Micky
NAME OF AGENCY:
City of Miami2111
OFFICE OR POSITION
COMM1SSionet Fri
`IF HIAMI BEACH
IF THE CITY CLERK
MAILING ADDRESS:
900 Bay Drive #504
CITY:
Miami Beach
COUNTY:
Miami-Dade
ZIP:
33141
FOR QUARTER ENDING (CHECK ONE): YEAR
UMARCH lieJUNE IZISEPTEMBER 0 DECEMBER 20 17
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
RECEIVED
DESCRIPTION
OF GIFT
MONETARY
VALUE
NAME OF PERSON
MAKING THE GIFT
ADDRESS OF PERSON
MAKING THE GIFT
03/01/0
Witi4-ct par 1/41 VIP .
i exk-l-e4t T2- e CeP Algo-) it' )00 - Alai iod A 1—
i.0 CTO
lletQL 'For- 4.e.
001 teirlitv4 erohFeti Rd
SoR c in.
Wet mt gee4cy, Fa. 3314o
U 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.
IJ CHECK HERE IF A RECEIPT IS ATTACHED TO THIS FORM
PART C OATH
STATE OF FLORIDA
COUNTY OF
MA -AM
Sworn to (or affirmed) and subscribed before me this
63) day of 5,0137-6p-A1> LA-. 20
I.
by 111 LN 13t6:--(to
(Signature of Notary Public-State of Florida)
(Print, Type, or Stamp Co missioned Name of Notary Public)
Personally Known r/- OR Produced Identification
Type of Identification Produced P62soutpto-i- K-Now
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 112.3148,
Florida Statutes.
1A SIG ME OF REPORTING OFFICIAL
PART D — FILING INSTRUCTIONS
This form, when duly signed and notarized, must be filed with the Commission on Ethics, P.O. Drawer 15709, Tallahassee, Florida 32317-570
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
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
CE FORM 9 - EFF. 1/2007 (Refer to Rule 34-7.010(1)(g), F.A.C.)(Rev, 612016) (See reverse side for instructions) co-
CUSTOMER COPY
09/06/2017 10:30AM 001709-0026 Adrian V
0.00 AMMO_dilq
Paid by: MICKY STEINBERG CAMPAIGN
II 111 III IIIII 111111111 111111111111
MBF
City Hall
1700 Convention Center Dr.
Miami Beach , FL 33139
305-673-7420
Welcome
MISCELLANEOUS
Description: MCR Expense
(MCREXP)
Reference 1: MCR416999
MCR Expense (MCREXP)
2017 Item: MCREXP
1 O 1,020.00
MCR Expense (MCREXP) 1,020.00
1,020.00
Subtotal 1,020.00
Total 1,020.00
CHECK 1,020.00
Check Number01007
Thank you for your payment
' RECEIVED
2011SEP -6 AM 10: 33