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Thomas Barker 12/31/2013 m MIAMI BEACH City of Miami Beach, 1700 Convention Center Drive,Miami Beach, Florida 33139,rcww.miamibeachfl.gov OFFICE OF THE CITY CLERK, Robert Parcher, City Clerk Tel: (305) 673-7411, Fax: (305)673-7254 12/29/2011 Thomas Barker 1770 Meridian Ave. #209 Miami Beach, Florida 33139 ISUBJ.EC T;�� Gay, Lesbian, Bisexual and Transgender Congratulations! You have been reappointed by Commissioner Michael G6ngora to the above referenced agency, board or committee for a term ending: 12/3112013. 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, 4obert Parcher City Clerk cc: Saul Frances, Parking Director Rebecca Wakefield 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 2-111 - 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. m► MIAMI BEACH City of Miami Beach, 1700 Convention Center Drive,Miami Beach, Florida 33139,www.miamibeachfl.g4_v OFFICE OF THE CITY CLERK, Robert Parcher,City Clerk Tel: (305)673-7411, Fax: (305) 673-7254 TO Thomas Barker RE: Gay, Lesbian, Bisexual and Transgender(GLBT) 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 1st,following the closing of the calendar year on wh" h I h rued. omas Barker Sworn to and subscribed before me this 3 day of Mx,"r� , 2012. ;r04 ilvia 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. li "® SOURCE OF INCOME STATEMENT Please.Print.or Type First Name Middle Name Initial Last Name Disciosure For Tax Year Ending'. Name: Mailing Address; City/State/Zip: �� • ��'t'�` �C3 S social.Security Number: Filing as a: ® Caunty Employee: ® Municipal Employee of: Position held or sought: Beard where serving: &VI"'"�rm or Employment r3rtfcvK.�+- L�' "' Began on:-teal Department where employed: Work Address: If your home address is exempt from public records pursuant to ® Work Telephone: Florida statutes§114./07 please check here(reed instructionO Home Address: C rl� (.1G I Street Address /h iQ�� ��-`� f-L- 31C3 l city State. 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 p 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: Description of the'Principal Name of Sourc of Income Address Business Activi I hereby swv r (:or afn )that the aforesaid information is a true and correct statement. Date signed Signature of person disclosing MIAMI BEACH city of Miami Beach, 1700 Convention Center Drive, Miami Beach, Florida 33139, www.miomibeachfl.aov CITY CLERK Office CityClerkCmiamibeachfl.gov 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) Board Member name: 1 understand that no later than July L 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 lax 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. Signature: Date: