The URL can be used to link to this page

Mitchell Korus 12/31/2011 'mss 02 -24 -2011 Mitchell Korus 5757 La Gorce Drive Miami Beach, Florida 33140 SUBJECT: Police Citizens Relations Committee Congratulations! You have been appointed by Mayor Matti Herrera Bower to the agency, board or committee named above for a term ending: 12/31/2011. Pursuant to Ordinance No. 2006 -3543, commencing with terms beginning on or after January 1st, 2007, the term of board members who are directly appointed by a member of the City Commission shall automatically expire on December 31 of the year the appointing elected official leaves office. If you are unable to accept this appointment or have any questions, please call the City Clerk's Office at 305 - 673 -7411. Please read the enclosed materials carefully. Congratulations again and good luck. Sincerely, 1 - 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 -458 and 2 -459 Ordinance No. 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 Employee CA MIAMIBEACH City of Miami Beach, 1700 Convention Center Drive, Miami Beach, Florida 33139, www.miamibeachH.gov OFFICE OF THE CITY CLERK, Robert Parcher, City Clerk Tel: (305) 673 -7411, Fax: (305) 673 -7254 TO Mitchell Korus 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: 12/31/2011. 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 theFlorida 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 depe ■ ing on the board or committee on which I serve) on July 1st, following the closing of the cal- i a �y =C r on which I have served. Mitchell Koru /� Sworn to and subscribed before me this a3 day of re -, 2011. 4)/2._—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. iA • tv\1 A/\A 1 B EAC CITY OF MIAMI cs ACi -1 _d.S a E:OAPIi AND COMIv i T E AP PL IVION FORM NAME: ' .� 1 L. st Name F t Name • Middle Initial HOME ADDRESS: S 5 L ` •-C-e F ' q 11 At, �4 ',1„ - 0 H N Apt No. o e o. /Street qty State Zip Code PHONE: 4 j; :i.a1 Tarr Mi► r II �.fs 1. , . - `fit if . As . Home t 4o' i F -e--_ Email address (.' Business Nam-: 1 Du ,.i Oftlf 4 ' •. ition: fa ! 112 L. • P Address' • ♦ MCI M • t / Y1 %4. _ "'f � _ °� /l • S treet C ` S� ip Code Professional License (describe) r. Mr& ' ! ~' a+/ z •Tres: ` . �� _ _�. [ t time?) Copy of ti, lice�3$2 Pursuant to City Code section 2 -22(4) a and b: Members of agencies, boards, , d committees shall be affiliated with the city: this requirement shall be fulfilled in the following ways: a) an individual shell have been a resident of the city for a minimum of six 1 months: or b) an individual shall demonstrate ownership/interest for a minimum of six months in a business established in the city. • Resident of Miami Beach for a minimum of six (6) months: Yetor No ❑ • Demonstrate an ownership/interest in a business in Miami Beach for a minimum of six (6) months: YesX or No u • Are you a registered voter in Miami Beach: Yes or No 0 • (Please circle one): I am now a resident of: North Beach South Beach die Bca • 1 am applying for an appointment because 1 have special abilities, knowledge and experience. Ptedbe List below: • Are you presently a registered lobbyist with the City of Miami Beach? l'f3 0 or No Please list your preferences in order of ranking [1] first choice [2] second choice, and [3] third choice. Please note that only three (31 choices will be observed by the Cit Clerk's Office. (Regular Boards of City) 0 Affordable HousinfjAdvisory Committee 0 Housing Authority 0 Art in Public Places Committee ❑ Loan Review Committee X eesutificetion Committee u Marine Authority 0 Board of Adjustment' 0 Miami Beach Commission for Women 0 Budget Advisory Committee 0 Miami Beach Cultural Arts Council Capital Improvements Pro Oversii ht Committee 0 Miami Beach Sister Cities Program Committee on the Homeless 0 Normandy Shores Local Government Neigh. improvement 0 ommittee for Quay Education in MB _ ❑ Parks and Recreation Facilities Rnard 0 Community Development Advisory 0 Personnel Board 0 Community Relations Board 0 Planning Board' 0 Convention Center Advisory Board 0 Police Citizene Relations Committee 0 Debarment Committee 0 Production Industry Council 0 Design Review Board' 0 Public Safety Advisory Committee D Disability Access Committee ❑ Safety Committee 0 Fine Arts Board 0 Single Family Residential Review Panel 0 Gay, Lesbian, Bisexual and Transgender (GLBT) 0 Sustainability Committee >stGolf Aavlsory Committee 0 Transparency Reliability & Accountability Committee "TRAC" 0 Health Advisory Committee 0 Transportation and Parking Committee 0 Health Facilities Authority Board 0 Visitor and Convention Authority 0 Hispanic Affairs Committee 0 Waterfront Protection Committee 0 Historic Preservation Board 0 Youth Center Advisory Board 'Board Required to File State DISclosure Form Note. If a pplying for Youth Advisory Board, please indicate your affiliation with the Scott Rakow Youth Center. 1 Past service on the Youth Center Advisory Board: Yee 0 N oars of Service: 2. Present participation in Youth Center activities by your ildren YesO No n. 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: 1 \CLER`.` ALL\ oFORM$ \GUARD AND CCIMMIll' i•S \ Bc_ Appli,nrionOb2rm NEW.doc 9 t%'[i /C;e1 3 =;"%d Alid36 1d1118IA IIEETESSOE gZ :Zi 6002 /EZ /Zi I • Have you ever been convicted of a felony: Yes 0 or No�f yes, please explain in detail. • Do you currently have a violation(s) of City of Miami Beach codes: Yes U or No If yes, please explain in detail: • Do you currently owe the City of Miami Beach any money: Yes or Ny if yes, explain in detail • Are you currently serving on any City Boards or Committees: Yt r No 0. If yes; which board? k • What organizations in t� iami Beach do you currently hold membership tt j City Y Y � in? Name: __�1 o4 4 Title: L A Name: , .i ...V i s . ..;,e,-.. • '.L—, . . 1 le: • List all properties o - • hay- an interest in which are located ' hin the City of Miam each: S - ,o i' :. . 1 (c,i ( .-1 t `ice ( ice KO • I am now employed by the City of Miami Beach: Yes U or departme . • Pursuant to City Code Section 2 - (b): Do you have a parent 0, spouse 0, child 0, brother 0, or sister 0 who is employed by the City of Miami Beach? Check all that apply. Identify the department(s): 1, r tU Tho following Information Is voluntary and Is neither part of your application nor has any bearing On your consideration for appointment It Is being aukod to comply with federal equal npportl+nity reporting requirements. Gender: , ale ❑ Female Et n Origin: Check one only (1) hits (Not of Hispanic Origin): All persons having origins in any of the original peoples of Europe, North Africa or the Middle East. 0 African American/Bleck (Not of Hibpianie Oiiyin): All persons having origins in any or the Black racial groups of Africa. 0 Hispanic: Aft persons of Mexican, Puerto Rican, Cuban, Central or South American, or other Spanish culture or origin. regardless of race, 0 Asian or Pacific Islander: All persons having origins in any of the original peoples of tho Far East, Southemct Asia. the Indian Subcontinent, on the Pacific Islands. This area includes. for example, China, India, Japan, Korea, the Philippine Islands and Somoa. 0 American Indian or Alaskan Native: All persons having origins in any of the original peoples of North America, and who maintain Cultural Identification through tribal affiliation or community recognition, Physically Challenged: Yes 0 or l Employment Status: Employed / kJ Retired 0 H omemaker 0 Other 0 NOTE: If appointed, you will be required to follow certain laws which apply to city board/committee members. Thos° Iowa include, but aro not limited to, the following: o Prohibition from directly or indirectly lobbying city personnel (Miami Beach City Code section 2 - 459). o Prohibition from contracting with the city (Miami - Dade County Code section 2 11.1). o Prohibition from lobbying before boardwcommittee you have served on for period of one year after leaving office (Miami Beach City Code section 2 -26). o Requirement to disclose certain financial interests and gifts (Miami - Dade County Code section 2 11.1). (re: CMS Community Development Advisory Committee): prohibition, during tenure and for one year after leaving office, from having any interest in or receiving any benefit from Community Development Block Grant funds for either yourself , or those with whom you have business or immediate family tips (CFR 570.611). Upon request, copies of these laws may be obtained from the City Clerk. "1 hj - b : ttest to the accuracy a I • • . fulness of the application and have received, read and will abide by Chapter 2, Arti r� w1 of e City Co. - ' :. ndards of Conduct for City Officers, Employees and Ag .ncy Members." Appl � Ignature 1Z`l � ` ttr[CJIt, P S g Date Name of Applicant (PLEASE PRINT) PI_ Atttich. a ca_py . fr►utilo to this.applicatlon NOfiE;,,Applls a or real) rofna r 9 J f110 iP! a Period of °M ill S.itlOndary0yl[. .1 4 % . r r //O4 !o ei ° Sf _ /r7 Received in the City Cleric's Office by : Date: ► Control Date: ( /200 ame of Deputy ' erk ,4% t'0/ EO 3917d Ai 1 'lThIl1 tIEETESSOE 9Z :Zt 6092 /EZ /ZT 12/ 12:20 3055313311 VIRTUAL REALTY PAGE 04/04 • .# 4375721 STATE OF FLORIDA 1 DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION DIVISION OF REAL ESTATE SEQ# L09040301443 DATE BATCH NUMBER LICENSE NBR )4/03/2009 080325626 BK3001316 'he BROKER tamed below IS LICENSED Tnder the provisions of Chapter 475 FS. :xpiration date: MAR 31, 2031 ., KORUS, MITCHELL P 5757 LA GORCE DR MIAMI BEACH FL 33140 CHIS.RLIE CRIST CIIA.RLES W. DRAGO GOVERNOR DISPLAY AS REQUIRED BY LAW SECRETARY MIAMI BEACH City of Miami Beach, 1700 Convention Center Drive, Miami Beach, Florida 33139, www.miamibeachfl.gov CITY CLERK Office CityClerk@ m i amibeachfl.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(1) (2) Board Member name: / ! 1LL- , I( /2 z) 5 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 for a period not to exceed sixty days, or both. Sig 1 .ture: Date: MIAMI= COUNTY SOURCE OF INCOME STATEMENT Please Print or Type First Name Middle Name /Initial Last Name Disclosure l For Tax Year if, l�C�E' (4)a-k)C Ending: ` (� / V Name:, — Mailing Address: c �..'illIt_ ._• ' 39/v 0 City /State /Zip: ll , ` � I . \� J` 1 Social .security Number: - Filing as a: ® County Employee: yrunicipal Employee of: CAA/{ Position held or sought: C vv , 0 , 1 ,� Board where serving: Term or Employment � k CS- C Ay----t,-, Began on: 2 I Department where employed: ��//�� l Work Address: l " t ( rr ,-��yy` »1 Ui 1 If your home address is exempt from public records pursuant to 3 IV 7 PL( Florida Statutes § 118.07 please check here (read instructions): Work Telephone: Home Address: ci C7 f CQ_ n Street Addr (`f ity Sta e 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 for your benefit or use during the disclosure period. The income of your spouse or any business partner need not be disclosed. If continued on a separate sheet, check here: El Description of the Principal N e of Source of Income Address Business Activi p -• gir r I y v 7 7 t 1/4 Wr_ t . AVII Si M �`� - 111111111 ITi111 EMI 1 I her _ r (or affirm) that the aforesaid information is a true and correct statement. 4.11tallA ").42- (I �"' Date signed Signatu �a �� on disclosing ned g J