Sasha Boulanger 12/31/2013 trA MAMI BEACH
City 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
1/10/2012
Sasha Boulanger
826 Raymond Street
Miami Beach, Florida 33141
re!B I�IE �, ° Marine Authority
Congratulations! You have been reappointed by Commissioner Ed Tobin
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.
AVe)47-P-LA/Cf
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 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 safety to all who live, work and play in our vibrant, tropical, historic community
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Cori of,14,1a,mk'BeaCh, 1700 Convention Center Drive,Miami Beach, Florida 331.39,www.miamibeachfl,gov
,o ,Ffe.Fic)F.THOCErr cLEOK,.ROpert Parcher,City Clerk
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TO Sasha Boulanger
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„..,-. RE. Marine Authority
I do solemnly swear or affirm to bear true faith,loyaltyandiallegiance19 the Government of
United States tri.e.Stateiof Florida,and the City-bf.Miami)tiegetu,an:',I.,100etfOrMaltithe duties of .
,.' a member ofthe-abOV&Mentioried.board or committee of the City Of4Vlia'r4i,13each,to which I have
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MIAMIBEACH
City of Miami Beach,
1700 Convention Center Drive,
Miami Beach, Florida 33139,
www miamibeochfl.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: E,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 ofthe 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.
'flu /0, 02 ° (
Sign-0, Dote•
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M;M f SOURCE OF INCOME STATEMENT'
J
Please Print or Type First Name Middle Name/Initial Last Name
Disclosure
Name: '745/X t.1,4 1,14/°C For Tax Year
Ending.
Mailing Address: Q. 4 Cc.`/M Cr•�e4 i�
City/State/Zip:
„,yl {art, flee. FC 3 3/yi
Social Security Number:
Filing as a: ® County Employee:
® Municipal Employee of:
Position held or sought:
Board where servin g:RIA •//� Auj/h,ei
Began on: / / / a--
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); 0 Work Telephone:
Home Address:
Street Address
City State Zip Code
i
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
I income of your spouse or any business partner need not be disclosed. If continued an a
separate sheet, check here: 0 J
I Description of the Principal
Name of Source of Income Ad•re Business Activi
SO leg.C A.,C.f./ .fu (4/ r4 ...- AV2 'C t; J r Z 0c-
Z hereby swear(o . .irm) that the aforesaid information is a true and.correct statement.
Sig - ure o arson disclosing Da - signed