Lisette Goldstein 12/31/2013r
City of Miami Beach, 1700 Convention Center Drive, Miami Beach, Florida 331 39, www.miarnibeachA.aov
OFFICE OF THE CITY CLERK, Robert Parcher, City Clerk
Tel: (305) 673-741 1, Fax: (305) 673-7254
2/29/2012
Lisette Goldstein
1405 West 24th Street
Miami Beach, Florida 33140
bj JE�CT,:- ' Art in Public Places
Congratulations! You have been reappointed by the City Commission 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,
U `'
Robert Parcher
City Clerk
cc: Saul Frances, Parking Director
Dennis Leyva
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.
® MIAMI BEACK ' .. .
City of Miami Beach, 1700 Convention Center Drive, Miami Beach, Florida 33139, www.miamibeochfl.aov
OFFICE OF THE CITY CLERK, Robert Parcher, City Clerk
Tel: (305) 673-7411, Fax: (305)673-7254
TO Lisette Goldstein
RE: Art in Public Places
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 board or committee on which
I serve)on July 1 st,following the closing of the len ar year on which I have served.
Lisette GoIc s ein
Sworn to and subscribed before me this day of harC-tri 2012.
Silvia Pr/V,
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
1
F ® - S�Ui�'CE OF 'TNr_0ME STATEMENT
'Please.Print.or Type First Name Middle Name/Initial Last Name
Disclosure
.�� For Tax'Yaar /
Name: Endir+g; azl
Nia"ding ,address:
Cityr/State/Zip
Filing as S: ® County Employee:
Municipal Employee of:
position held or sought:
Tenn or.E
Smairld where serving: � ! mp><cyment
'began crtt,
Deparl:rnent'where SMOWBd:
work Address:
If your-home addrew is==Wt fmm pnbDo records purwmnt b '.ID Work T•elB lti one:
Florid®statutes j=5X7 pimse check home(rand instructions); p
1 Horne/address: strest Address
I
.Zip Code
City
e name address and
Please.fist below in descandin order with the largest source�rirs the tahfic.salary you
principal business activity .of every source of your inwme including P
received or any person-recsnrad fur your.benaf'tt or use during the tiisclQSVr� period. The
•incorne of your spouse or any business partner nand not be disclosed. If continued on
separate sheet; check here: 13
Description of the Principal
Business Activ
T4 me of sou e.of Incorne l�0 Ad ss ` S ` f
i
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hereby swear (or affirm)that the aforesaid information is:e�teue.and =orract statement,
.Date signed
:signature QT.pa disclosing
m MIAMI BEACH
City of Miami Beach,.
1700 Convention Center.Drive,
Miami.Beoch,Florida 33139,'
www.miamibeochfl.aov
CITY CLERK Office CityClerk@miomibeochfl.gov
Tel:305.673.74 11 Fox: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 nam
W_Mki #J
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 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 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 he county jail for a period not to exceed sixty days, or both.
Signature: Date:
F:\CLER\$ALL\aFORMS\BOARD AND COMMITTEES\BC Application.doc