Stephanie Rosen 12/31/2013 (2) MIAMIBEACH
City of Miami Beach, 1700 Convention Center Drive,Miami Beach, Florida 33139,www.miamibeachfi.gov
OFFICE OF THE CITY CLERK, Robert Parcher, City Clerk
Tel: (305) 673-7411, Fax: (305)673-7254
1/6/2012
Stephanie Rosen
325 N. Hibiscus Drive
Miami Beach, Florida 33139
,,;.,,
iSUBJECTx- Youth Center Advisory Board
Congratulations! You have been reappointed ppointed by Commissioner Deede Weithorn
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
Ellen Vargas
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.
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 Stephanie Rosen
RE: Youth Center Advisory Board
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: 12/31/2013.
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(depending on the r committee on which
I serve)on July 1st,following the closing of the calendar year hich I have serve
Sworn to and subscribed before me this day of , 2012.
F 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.
I
M
I AM I BEAC.H.
city of Miami Beach,
1700 Convention Center Drive,
Miami Beach, Florida 33139,
ww .miomibeochfl.no
C(TY CLERK Office City Clerk CmiamibeochfLgov
Tel: 305.673.741 1 , 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)
4Z-- `�Ro_s E'd
Board Member name:
I understand that no later than Judy I1, 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,mustfile., 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 Miam-i-Dade.County Code Chapter 1, General
Provision, Section 1.6 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.
Si ate:
MIAMI-
OE SOURCE OF INCO ME .STATEMENT•.
Please.Print.or Type First Name Middle Name Inal Last Name Disclosure
• // For'Tax Year
Name:
Ending: Z/
&00,
Mailing Address:
city/state/zip:
Social security Number:
Filing as a: ® County Employee:
Municipal Employee oh
Position held or sought:
Board where serving: ® ' ��S Terra or.Empl® m nt
Department-where ernploYed:
Work Address:
if.your-home address is exempt from public records pursuant to ® �Aio
P rIC T®1® done:
Florida statutes§119.07 please check here(read instructions):
Home Address-
Streetji��,
pity State. alp Code
please list below in descending order with the largest source first,the naive,address and
l public principal business activity of every source of your income including P salary you
received or any person received for your benefit or use during the disclosure period.
on
:income-of your..spouse or-any business partner need not be,disclos
separate sheet, check here:
"Description of the'Principal
Name of source of.Income Address � Business Activri
Thereby swe affirm)th he aforesaid information is:a true and .correct statement.
s' ature of person disc ' 9 D to signed