Daniel Kipnis 12/31/2013 MIAMI BEACH
City 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
12/29/2011
Daniel Kipnis
3156 Royal Palm Ave.
Miami Beach, Florida 33140
SUBJEll Marine Authority
Congratulations! You have been reappointed by Commissioner Jonah M. Wolfson
to the above referenced agency, board or committee for a term ending. 12/31/2013.
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,
Robert Parcher
City Clerk
cc: Saul Frances, Parking Director
Jose Alberto
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 Section2-22
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 safety to all who live, work and play in our vibrant, tropical, historic community
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miAmIBEAcH
City 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 'Daniel"Kipnis
RE. Marine Authority
I do splernnyswear or affirattobeartrue faith, loyalty and allegiandelo Jhepovernment of the
United4Statesi-Ithe'State r of and the City'ofNliamijEleaCb,iandqo:_perfiliiiCiltthe duties of
.a,member of the!aboVementioned,board,or comMittee''`ollthe,0.ityiqMierhiAeach to which I have
beenrappoiriteit for aAerm.ending: 12/31/2013.
I haVe'jbeerii.S.Sueci.acopyOf Section 2-11 1 of the,;NiaMibatie-"County.'COde(Conflict of Interest
and Code of Ethias'ordinance)vaS well as theFidfida.Commission on.:EthieS:Guide.tathe Sunshine
Amendment and Cdde of Ethics-for Public.0fficerS:and:WdyeeSi and understand that as-a member „
of 6.304 Of Miami Be.aC,INIJoardand/or Committeel must comply WithYtheiiihandial ditcloSure'reetuire-
..
merits of Miarrii-Dade)Poti r4 or the State of Floride:.(dependifigOri,theb4r-d cir.:COrtmiittee on whiCh'r
_
serve)on July 1st following the closing of the'c'elefidarTyear on4which,14iivelservetl.
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Sworn to and subscribed before me thi day of __ ,
7P.&/94 12
Silvia Prieto
Deputy Clerk
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*please visit thCityofMiamiBeach website at wwvv.miannibeachfl.gpvtunder-City..c.lerkffloard and,Committees,
for additional information regarding the Financial Disclosure Requirements.
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We are comdmitted r
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to providing-eic'ellene:0b4 service and safely to all who live, workand,Olayiinpurvibtran't;irbpiCaGlitStario communily
M !AMIBEACH
City of Miami Beach,
1700 Convention Center Drive,
Miami Beach, Florida 33139,
www miamibeachfl gov
CITY CLERK Office CityClerk@miamibeochfl.gov
Tel:305.673.7411 , Fax: 305 673.7254
Acknowledgement of fines/suspension for Board Mem hers for failure
to comply with Miami-Dade County Financial Disclosure Code Provision
Code Section 2-1 1.1(1) (2)
Board Member name: D7/1V?gz- "A" S
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 ofithe 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(on
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.
q411.4414: ///Signature: Dot :
!
MIAMI= p� �y
COUNTY SOURCE OF INCOME STATEMENT
Please Print or Type First Name Middle Name/Initial Last Name
Disclosure
Name: 1041W EL C. /< /Pit//S. For Tax Year
/ Ending:,a�j l/
Mailing Address: - . % /,p/ - f1 v
II City/State/Zip: In 1 4141 4 R_ 3//0
Social Security Number: 2-, ' 74
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Filing as a: ® County Employee:
1 ® Municipal Employee of:
Position held or sought:
1 Board where serving: ,(/- f ,( bf� Term or Employment
Began nn: j,E}A/ S y0/2_-
Department where employed:
Work Address:
If your home address is exempt from public records pursuant to
Florida Statutes§119.07 please check here(read instructions): CI Work Telephone:
Home Address:
Street Address
City State Zip Code
Please Test 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 e
j `separate sheet, check here: ® l
I
Description of the Principal
Name of Source of Income Address Business Activity
/iv VV,I,1 4�T`
1
I hereby swear(or affirm)that the aforesaid information is a true and correct statement.
(?a/t4/ (f- / /e,i-e'>-"gr------ 7 /D / -----
Signature of person malosing Date igned