Amy Perry 12/31/2013 IM MIAMI BEACH
City of Miami Beach, 1700 Convention Center Drive,Miami Beach, Florida 33139,www miamibeochfl._qov
OFFICE OF THE CITY CLERK, Robert Parcher, City Clerk
Tel: (305) 673-7411, Fax: (305) 673-7254
02-28-2012
Amy Perry
5133 N. Bay Road
Miami Beach, Florida 33140
;SUBJECT:. Affordable Housing Advisory Committee
Congratulations! You have been appointed by the City Commission to the agency,
board or committee named above for a term ending: 12/31/2013.
Pursuant to Ordinance No. 2006-3543, commencing with terms beginning on or after
January 1 st, 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,
Robert Parcher
City Clerk
cc: Saul Frances, Parking Director
Richard Bowman
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
We are committed to providing excellent public service and safety to all who live, work and play in our vibrant, tropical, historic community.
m 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 Amy Perry
RE: Affordable Housing Advisory 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: 12/31/2013.
1 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 board or committee on which
I serve)on July 1 st,following the closing of the calendar year on which I have served.
y Perry
Sworn to and subscribed before me this y y of��/u 012.
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.
0 •
MIAMI BEACH
City of Miami Seaeh,
1700 Convention Center Drive,
Miami Beach, Florido 33139,
v✓ww miamlbeochfl.poy
CTY CLERK Office CilyClark(Lamiamlbeachfl..gov
Tel: 305.673.7411 , Fax: 305.673.7254
Acknowledgement of fines/suspension for Board Mahn bars for failure
to comply with Miami-Dade County Financial Disclosure Code Provision
Code Section 2-11 .1 M (2)
Board Member name: E�/e
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 meansthat the
members of City Advisory Boards, whose soie or primary responsibility is to recommend
legislation or give advice to-the City Commission,-must fiie, even though you may-have been
recently appointed.
YOU -must f le one of the loliowing with the City Clerk of Miami Beach, 1700 Convention
Canter 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 lax Return
Failure to fie, according to the Miami-Dade .County [;ode Chapter 1, General
Provision, Section 1,5 may subject the person or firm to a fi ne not to.exceed
$500..00 or by imprisonment in the county,ji it for a period not to exceed sixty
days, or both.
- - � / �
– lAn4-p—Y
' nature: dots:
H
M® 5;OUR E DE IN OME STATEMEN T
PlBase.Print.orType First blame Middle Name/Initial Last Name
Disclosure
For Tax year /
if)/i
Ending:
Name:
Mailing Address: �l 3 N , 6/�
City/State/Zip:
Social.Security Number:
Filing as a: ® County Employee:
municipal Ernpioyee of.-
position held or sought:
F r or Emplcyme t
Board where serving, & �� �I eg n an: 'Z Z� / ?i
Department-where empiayed:
Work Address:
if your-home address is exempt fmm public records pursuant toOrIC T9}e heDnB:
Rlaride Statutes§ 11.9.137 plasse check here(read instrudions); P
Home Address: Street Address
City State. Zip Code
Please.list below in descending order with-the largest source first,the na bii a salary sou
principal business activity of every source of your income inciudir�g R r'S y
received or any person received for your banar{-tt or use during the disclosure period, The
-income of your spouse or any business partner need not be diseiosed. If continued on a
separate sheet, check here:
Desr ription of the Principal
Name of Source of Income Address
usirress Activi
hereb swear (Dr.affirm) that the aforesaid information is:a true and _-arrest statement,
ISignature of.person ciosing Date signed