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Statement of Financial Interest FORM 1 STATEMENT OF 2002 Please print or type your name, mailing I FINANCLALINTERESTS I address, agency name, and posllion below: LAST NAME -FIRST NAME -- MIDDLE NAME: FOR OFFICE Sopher Jacob 1. USE ONLY: MAILING ADDRESS: - 1500 Bay Foad #514 . ID Code - CITY: ZIP: COUNTY : M;.::lm; ..... -'- Miami -Dade IDNo. e> <3 ~ 33139 ~ NAME OF AGENCY: ../... ~ Conf. Code Cl "*0 (') ~ \ (1'\ NAME OF OFFICE OR POSITION HELD OR SOUGHT: P. Req. Code cJ' L Miami Beach Conmissioner Group IV ~ -() - cP -:s, ~ CHECK IF ~ CANDIDATE OR D NEW EMPLOYEE OR APPOINTEE ~ s:- ., ~ e9F 2002 ~ - "*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 (check one): [i] DECEMBER 31, 2002 QB D 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 instruclions for rurther details). PLEASE STATE BELOW WHETHER THIS STATEMENT REFLECTS EITHER (check one): 88I COMPARATIVE (PERCENTAGE) THRESHOLDS QB U DOLLAR VALUE THRESHOLDS PART A -- PRIMARY SOURCES OF INCOME [Major sources or income to the reporting person] NAME OF SOURCE SOURCE'S DESCRIPTION OF THE SOURCE'S ,..... 'M"OME \ ADDRESS PRINCIPAL BUSINESS ACTIVITY --- -- ----------- ~see kcrw .}-T~ ..~ ------ - -- - 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' INCOME OF SOURCE ACTIVITY OF SOURCE to.... . -- - -~ jJ ~rt A-cti-P b --_. - ' ---- .- ----- ---- - PART C - REAL PROPERTY [Land, buildings owned by the reporting person] FILING INSTRUCTIONS for when -""" and where to file this form are locat- '----- ~ ed at the bottom of page 2. ;>' .---- ^.----:- ~ ~ INSTRUCTIONS on who must file - - this form and how to fill it out begin ~ t::it:: /1LI !1Lf ( , I. .J "'- on page 3. , ~ "-- OTHER FORMS you may need to /" file are described on page 6. \ CE FORM 1 - Eff. 112003 (Continued on reverse side) PAGE 1 i {~ . -- " ... , PART 0 - INTANGIBLE PERSONAL PROPERTY [Stocks, bonds, certificates of deposit, etc.] TYPE OF INTANGIBLE BUSINESS ENTITY TO WHICH THE PROPERTY RELATES PART E - LIABILITIES [Major debts] NAME OF CREDITOR ADDRESS OF CREDITOR 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 SIGNATURE (required): WHAT TO FILE: After completing all parts of this fonn, including signing and dating it. send back only the first sheet (pages 1 and 2) for filing. NOTE: MULTIPLE FILING UNNECESSARY: Generally, a person who has filed Fonn 1 for a calendar or fiscal year Is not required to file a second Fonn 1 for the same year. However. a candidate who previously filed Fonn 1 because of another public position must at least file a copy of his or her original Fonn 1 when qualifying. CE FORM 1 - Eff. 112003 TINUEO ON A SEPARATE SHEET, PLEASE CHECK HERE DATE SIGNED (required): 9/5/2003 CTIONS: WHERE TO FILE: If you were mailed the fonn by the Commission on Ethics or a County Supervisor of Elections for your annual disclosure filing, retum the tonn to that location. Local offlcwslemployees file with the Supervisor of Elections of the county in which they perma- nently reside. (If you do not pennanently 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. Candidates file this fonn together with their qualifying papers. To detennine what category your position falls under, see the "Who Must File- Instructions on page 3. WHEN TO FILE: Initially, each local officer/employee, stale officer, and specified state employee must file within 3D days of the date of his or her appointment or of the beginning of employ- ment. Appointees who must be confirmed by the Senate must file prior 10 confinnalion, even if that is less than 30 days from the date of their appointment. Candidates for pubHcly-elected local office must file at the same time they file their qualifying papers. Thereafter, local officers/employees, slate officers, and specified slate employees are required to file by July 1st following each calendar year in which they hold their posi- lions. Finally, at the end of office or employment, each local officer/employee, state officer, and specified state employee is required to file a final disclosure fonn (Form 1F) within 60 days of leaving office or employment. PAG:4 ~ 09/05/2003 14:51 FAX 212 223 0072 BECKER & CO. LLC. Part A - Primary Sources of Income: Source Quik Park Garage Corp. and Affiliates J acco Realty u..c Address 425 East 61'1 Street New York, NY 10021 425 East 6111 Street New York, NY 10021 Business Activity Parking Garages Apartment rentals and cooperative apartment sales ~ 002/007 i ~~ 09/05/2003 14:51 FAX 212 223 0072 , , Part B - Secondaly Sources of Income: None BECKER & CO. LLC. ~ 003/007 qtb 09/05/2003 14:51 FAX 212 223 0072 Part C - Real Property; CommeIcial Properties (15) Located in Miami. Florida and Miami Beach. Florida (Details to be provided by amendment to this Form 1) Condominium Apartment #141 125 Jefferson Ave. Miami Beach, Florida Condominium Apartment 42201 Fisher Island Drive Fisher Island. Florida BECKER & CO. LLC. ~ 004/007 s~~ 09/05/2003 14:51 FAX 212 223 0072 Part D - Intanpble Personal Pro,perty: Type of Intan~ble Stock., LLC Membership Interests and Partnership Interests LoanlNotes Receivable BECKER & CO. LLC. Business Entity to Which the Property Relates Quik Park Garage Corp. and Affiliates Quik Park Garage Corp. and Affiliates ~ 005/007 ~ ~ t 09/05/2003 14:51 FAX 212 223 0072 BECKER & CO. LLC. ~ 006/007 Part E - Liabilities: None j.,q 09/05/2003 14:51 FAX 212 223 0072 Part F: Interests in Specified Businesses: None .bI1JSDJS<1OStnm9503 BECKER & CO. LLC. III 007/007 ,\J ~ . ~Vb