Walker Burttschell 12/31/2013 ® MIAMI BEACH
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
02/28/2012
Walker Burttschell
435 21st Street #212
Miami Beach, Florida 33139
S.UBJ'EC'T Miami Beach Human Rights Committee
Congratulations! You have been reappointed by the City Commission to the above
referenced agency, board or committee for a term ending: 1213112013.
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
Ralph Granado
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.
IM MIAMIBEACH
City of Miami Beach, 1700 Convention Center Drive,Miami Beach, Florida 33139,www.miomibeachfl.gov
OFFICE OF THE CITY CLERK, Robert Parcher, City Clerk
Tel: (305)673-7411, Fax: (305)673-7254
TO Walker Burtschell
RE: Miami Beach Human Rights 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 theFlonda Commission on Ethics Guide to the Sunshine
Amendment and Code of Ethics for Public Officers and Employees,and understand-,I a member
of a City of Miami Beach Board and/or Committee, I must comply with inanck disclo re`require-
ments of Miami-Dade County or the State of Florida(depending he board or commi ee on which
I serve)on July 1st,following the closing of the calendar year which I have serve
Walker B s elll
Sworn to and subscribed before me this ay of /eC! .2012.
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.
MIAMIBEACH
city of Miami Beach,
1700 Convention Center Drive,
Miami Beach, Florida 33139,
www miamlbeochfl.avv
Cf'rY CLERK Office CffyClerl C m i arnlbeachfl.,gov
Tel: 305.673.7411 , Fox: 305.673.7254
Acknowledgement of fines/suspension for Board Mena hers for failure
to comply with Miami-Dade County Financial Disclosur-e Code Provision
Code Section 2-11.1 U) .(2)
Board
Member name.
understand that no later than.duly '1 , of each year all members of Boards and
Committees of the City of Miaml :9each, 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 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.
Yc)u mustfile one of the following with the City Clark.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
'Faiiure to fiie, according to the Miami Dade .County Code Chapter 1, General
Provision, Section 1 Z may subject the person or firm to a fill ne not to.exceed
"$5DD.00 or by imprisonment in the county jail for a.period n®t to exceed.sixty
stays, or both.
Signature: Data:
N
MIAMI. SOURCE OF �If�lC�ME STATEMENT
M�
pisase.print.orType First Name Diddle Name/Initial Last Name
Disclosure
For Tax year
Ending;2v�/
Name:
Mailing address;
� t
city/State/zip: /'}� ✓r��' L . �G
um
Filing as a: ® County Employee:
® Municipal Employee of:
position held or sought:
�I/f�j �R Term or Employment
Board where serving:
'.Began on; Z Z
Department Where empleyed:
Work Address:
If your-home address is exempt trim public raeardspursuant to 1A►DrIC Teie i eDne:
Florida Statutes 118.07 please check here(read instructions); P
Hoene Address: Street Address
city State. .Zip Code
Please.list beiovu in descending order with the largest source first,ti,e name-, salary and
principal business activity of every source of your income inciuding p ry you
received or any person received for your benefit or use during the disalctsure period. The
.income of-your spouse or any business partner need not be disciosed. If continued on"e
separate sheet, check here:
DescriptiDn of the Principal
Name of Source of Income Address
Business Activity
1 hereby suvear (or affirm) t the oresaid information is:e true.and correct statement.
Signature of.person CIS 51 Date signed