Steve Oppenheimer 12/31/2012 ..„/
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Cit of Miami Beach, 1700 Convention Center Drive, Miami Beach, Florida 33139, www.miamibeachflyov
OFFICE OF THE CITY CLERK, Robert Parcher, City Clerk
Tel: (305) 673-7411, Fax: (305) 673 -7254
11/10/2010
Steven Oppenheimer
4645 N. Bay Road
Miami Beach, Florida 33140
UBJE'C 4,# Police Citizens Relations Committee
Congratulations! You have been reappointed by Commissioner Jonah M. Wolfson
to the above referenced agency, board or committee for a term ending: 12/31/2012.
If you are unable to accept this appointment, please notify the City Clerk's Office at
(305) 673 - 7411.
Please read the enclosed material carefully. Again, congratulations and good luck.
Sincerely,
j<' /0.4pip
Q1?--el-L-eJy5t '
Robert Parcher
City Clerk
cc: Saul Frances, Parking Director
Chief Carlos Noriega
ATTACHMENTS:
Letter of Appointment
Oath
City Code Ordinance section, applicable to agency, board or committee •
City Code Section 2 -22, 2 -23, 2 -24, 2 -25, 2 -26, 2 -2458, 2-459
Ordinance 2006 -3543 - Amendment to City Code Section 2 -22
Miami -Dade County Code Section 2 -11.1 - Conflict of Interest and Code of Ethics Ordinance
City. Wide Permit Application - (Parking Department Form)
Booklet - Guide to the Sunshine Amendment and Code of Ethics for Public Officers and
Employees
We are committed to providing excellent public service and safely to all who live, work and play in our vibrant, tropical, historic community.
ea MIAMI BEACH
Cit of Miami Beach, 1700 Convention Center. Drive, Miami Beach, Florida 33139, www.miamibeachfl.gov
OFFICE OF THE CITY CLERK, Robert Parcher, City Clerk
Tel: (305) 673-7411, Fax: (305) 673 -7254
TO Steven Oppenheimer
RE: Police Citizens Relations Committee
I do solemnly swear or affirm to bear true faith, loyalty and allegiance to the Government of the
United States, the State of Florida, and the City of Miami Beach, and to perform all the duties of
a member of the above - mentioned board or committee of the City of Miami Beach to which I have
been appointed for a term ending: 12/31/2012.
I have been issued a copy of Section 2 -11.1 of the Miami -Dade County Code (Conflict of Interest
and Code of Ethics Ordinance), as well as theF/orida Commission on Ethics Guide to the Sunshine
Amendment and Code of Ethics for Public Officers and Employees, and understand that as a member
of a City of Miami Beach Board and /or Committee, I must comply with the financial disclosure* require-
ments of Miami -Dade County or the State of Florida (depending on the board or committee on which
I serve) on July 1st, following the closing of the calendar year on which I have served.
Steven Oppenheimer
d Y Sworn to and subscribed before me this/ Z day of / 4I 1 fh , 2010.
/ •
Silvia Prieto
Deputy Clerk
*Please visit the City of Miami Beach website at www.miamibeachfl.gov under City Clerk/Board and Committees
for additional information regarding the Financial Disclosure Requirements.
We are committed to providing excellent public service and safety to all who live, work and play in our vibrant, tropical, historic community.
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NAME: 2fttE v#G // (CA ,S 7 VEA/ aq t 3 ° F1112.. ' 5
Last Name First Name iuil nitial
HOME ADDRESS: 1. .. AA '3 ,4/ /f APA. 3 `C'r `,' (Alp � J `
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No. Street City State Zip Code
PHONE: VS' (3'Z ' /g0/ 34 • ,C3/ • Pi*/ .v p elv, 6/9,L-iti//A /mEQ.e ,4/4 /["'
Home Work Fax Email address . 412/`7
Business Name:- A �� 'A do i %o ` ' � cd '> )- : J-4n �E.--
) Pd ition: /�1../�•
Address: 'US ,a/L-Z 'b £Ol'C/ , • /i a it— 3/
No. v 41''P'1t t l � City State Zip Code
Professional License (describe) % 4 5 1 .1. Ex pires :a � // •:..._ ,..•
Pursuant to City Code section 2 -22(4) a and b: Members of agencies, boards, and committees shall be affiliated with the city; this
requirement shall be fulfilled in the following ways: a) an individual shall have been a resident of the city for a minimum of six
months; or b) an individual shall demonstrate ownershipfinterest for a minimum of six months in a business established in the city.
e Resident of Miami Beach for a minimum of six (6) months: Yes /or No U
• Demonstrate an ownership /interest in a business in !for
'' Miami Beach for a minimum of six (6) months: Yes No U
• Are you a registered voter in Miami Yes lyor No Li
s (Please check one): I am now a resident of: North Beach U South Beach U Middle Beach /
e 1 ammpplying for an,ppointment because I have special abilities, knowledge, experience. Please list below:
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1/ / /y -A 1 AA > /jysi si pi.,v/L.ER, C:1 0. yes) trhsr 1.a40t
' a te '.° 7 S t'r/ p, Act/ 4,74 i/ifi r
Please list your preferences in order of ranking [1] first choice [2] second choice, and [3] third choice. Please note that only three (3)
choices will be observed by the City Clerk's Office. (Regular. Boards of City)
0 Art in Public Places Committee
0 Beach Preservation Board 0 Housing Authority*
Zil Committee ❑ Loan Review Committee*
0 Board of Adjustment* 0 Marine Authority'
' 0 Budget Advisory Committee 0 Miami Beach Cultural Arm Counal
0 Committee on Homeless ❑ Miami Beach Commission for Women
D committee for Quality Education in MB ❑ Miami Beach Florida Sister Cities
❑ Community Development Advisory* ❑ Normandy Shores Local Gov't Neigh. Improvement
0 Community Relations Board 0 Oversight Committee for General Obligation Bond
0 Convention Center Advisory Board 0 Parks and Recreation Facilities Board
0 Debarment Committee 0 Personnel Board* ,
0 Design Review Board* 0 Planning Board*
0 Disability Access Committee Wolice Citizens Relations Committee 7
ri Fine Arts Board 0 Production Industry Coups
❑ Golf Advisory Committee ❑ Public Safety Advisory Committee
0 Health Advisory Committee 0 Safety Committee
OS leaith Facilities Authority Board 51/Transportation and Parking Committee 7 i-` 2
0 Hispanic Affairs Committee 0 Visitor and Convention Authority* '
a Historic Preservation Board* 0 Youth Center Advisory Ord
* Board Required to File State Disclosure form
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Note: if applying for Youth Advisory Board, please indicate your affiliation'with the Scott Rakow Youth Center:
1. Past service on the Youth Center Advisory Board: Yes U No U Years of Service:
2. Present participation in Youth Center activities by your children YesU No J. If yes, please list the names of your children, their
ages, and which programs. List below:
Child's name: Age:. • Program:
Child's name: Age: Program:
•Have you ever been convicted of a felony: Yes U or No /If yes, please explain in detail:
• Do you currently have a violation(s) of City of Miami Beach codes: Yes U or No ilf yes, please explain in detail:
e Do you currently owe the City of Miami Beach any money: Yes u or No LiIf yes, explain in detail
e Are you currently serving on any City Boards or Committees: Yes u or No / If yes; which board?
e What organizations in the City of Miami Beach do you currently hold Membership ire?
Name: Title:
Name:. • Title:
e List all properties owned or have an interest in, which are located within the City of Miami Beach:
e I am now employed by the City of Miami Beach: Yes Li or Nair ✓Which department?
• Pursuant to City Code Section 2 -25 (b): Do you have a parent U, spouse U, child U, brother U, or sister 1 who is employed by the
City of Miami Beach? Check all that apply. Identify the department(s): AA,
This section is "not required" but desired: Age: years old Gender: Male iV Female I.3
Ethnic Origin (Check one)
White 0 African - American/Black 0 Hispanic: 0 Asian or Pacific Islander 0 American Indian or Alaskan Native 0
Empfoyment Status: Employed 0 Retired 01 -tome -maker 0 Other 0
"1 hereby attest to the accuracy and truthfulness of the application and have received, read and will abide by Chapter 2, -
Article VII — of the City Code "Standards of Conduct for City Officers, Employees and Agency Members,"
- /i 3� v I ��vei / aY 1(4.1. / t f '
#cant s Signature ate Name of Applicant (PLEASE .PRINT) ,'
Please attach a copy of your resume to this application
NOTE: Applications will remain on file for a period of one (1) calendar year.
.. Received in City Clerk's Office by ` .
Date
Name of Deputy Clerk
Document Control Number (Assigned by the City Clerk's Office
? � � Enter By - Date /2-- /
Revised 1 29/204 L. fiatfiefet t
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American Association of Endodontists
Specialist Members
RICHARD MAUTNER, D.D.S.
STEVEN OPPENHEIMER, D.M.D.
Practice Limited to Endodontics
925 Arthur Godfrey Rd., Suite 207 2999 N.E. 191St St., Suite 602
Miami Beach, FL 33140 Aventura, FL 33180
Phone: (305) 531 -0841 Phone: (305) 682 -1795
Fax: (305) 531 -2808 Fax: (305) 682 -1706
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. . STATE OF.Ff;�C3 ll)�► ` . " `• :': AC# •• •
DEPARTMENT OF< EALTH
DIVISION?OF. �MEOICAL QUALITY ASSURANCE
• : `: `' LICENSE NO. , :
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na ed Belo :t as r ef:ail requirements of
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the laws and'rules of'the state of.Flonda.
; Irxp iratiot) Dade:: >:::> <;:; FEBRUARY 28, 2012 .
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Pit OPPENHEIMER •...• • '
•
LICENSEE SIGNATURE . '..
•
•
110 •
M3 SOURCE OF INCOME STATEMENT
Please Print or Type First Name Middle Name /Initial Last Name
Disclosure
7 4J� For Tax 'tear
Name: Ending:
Mailing Address; , ¥ AI �
°�
Crby /State/Zip: _) 4- /V)
Social Security Number:
Filing as a: CI County Employee:
Municipal Employee of:
Position Reid or sought:
'Board where serving: � J G t�S ' or Employment
gan on:
Department where employer!:
Work. Address: •
•
If your home address is exempt from public records pursuant to
Pioride Statutes § 2.2.s.U7 please check here (read instructions): Work Telephone:
Home Address;
• Street Address
City State Zip Code
Please list below in descending order with the largest source first,, the name, address and
principal business activity of every source of your income including public .salary you
received or any person received far your benefit or use during the disclosure period. The
income of your spouse or any business partner need not be disckcesed. If continued on e
separate sheet, check here: ED
Description of the Principal
Name of Source of Income Address Business Activi
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tL ai1 N �. a. Yni .�:
IVRICAuts Tv
hereby wear (or affirm) that the aforesaid information is a true and correct statement,
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Signature of person disclosing ate si ned
in MIAMIBEACH
City of Miami Beach,
1700 Convention Center Drive,
Miami Beach, Florida. 33139,
www.miamibeachfl.gov
CITY CLERK Office CityClerk @miamibeachfl.gov
Tel: 305.673.7411 , Fax: 305.673.7254
Acknowledgement of fines /suspension for Board Members for failure
to comply with Miami -Dade County Financial Disclosure Code Provision
Code Section 2- 11.1(i) (2)
Board Member name: W i 'iPt
I: understand that no later than July 1, of each year all members of Boards and
Committees of the City of Miami Beach, including those of a purely advisory nature, are
required to comply with Miami -Dade County Disclosure Requirements. This means that the
members of City Advisory Boards, whose sole or primary responsibility is to recommend
legislation or give advice to the City Commission, must file, even though you may have been
recently appointed.
You must file one of the following with the City Clerk of Miami Beach, 1700 Convention
Center Drive, Miami Beach, Florida, by July 1 each year
1. A "Source of Income Statement" (attached) or
2. A "Financial Statement" (attached( or]
3. A Copy of the person's current Federal Income Tax Return
Failure to file, according to the Miami -Dade County Code Chapter 1,. General
Provision, Section 1 -5 may subject the person or firm to a fine not to exceed
$500.00 or by imprisonment in the county jail for a period not to exceed sixty
days, or both.
....,:e-2 %/ 4-1
Signature: bate: