Rachael Zuckerman 12/31/2013 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
3/14/2012
Rachael Zuckerman
6538 Collins Ave. #311
Miami Beach, Florida 33140
T'' Committee on the Homeless
Congratulations! You have been reappointed by Commissioner Deede Weithorn
to the above referenced agency, board or committee for a term ending: 12131/2013.
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
Katherine Martinez
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.
1
® MIAMIBEACK '
City of Miami Beach, 1700 Convention Center Drive,Miami Beach, Florida 33139,www.miamibeachfl.aov
OFFICE OF THE CITY CLERK, Robert Parcher, City Clerk
Tel: (305) 673-7411, Fax: (305) 673-7254
TO Rachael Zuckerman
RE: Committee on the Homeless
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: 12/31/2012.
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 calendar year on w ' I have served.
Rachae Zuc erman
n
Sworn to and subscribed before me this r"1 day o 2012.
rD"llvia 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.
MIAMI BEACH
City of Miami Beach,
1700 Convention Center Drive,
Miami Beach, Florida 33139,
www.miarrilbeachfi.gov
CITY CLERK Office CityClerkCmiomibeachfl.gov
Tel: 305.673.741 1 , Fax: 305.673.7254
Acknowledgement of fines/suspension for Board Mernbers for failure
to comply with Miami-Dade County Financial Disclosure Code Provision
Code Section 2-11.1(i) (2)
Board !Member name:
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 the county,jail for a period not to exceed sixty
days, or both.
Signature: Date:
r.
MIAMI
SOURCE OF INCOME STATEMENT
Please.Print.or7ype First Name Middle Name Initial Last Name
Disclosure
��C For'Tax Year
Name: /
Ending;'f O<�
Mailing ,address;
city/state
r:
Filing as a: ® County Employee:
® Municipal Employee of:
Position held or sought:
Board where sarving: Term or Emplayment
Began.on: y �T/
Department-Whare employed:
Work Address: L
if your home address Is exempt from public records pursuant to � WOrIC Telephone:
Florida Statutes§118.07 please check here(read instructions); P
Home Address:
Street Address
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 public salary you
received or any.person received for your benefit.or use during the disclosure period. "The
;inconne of your.spouse or-arty,business partner need not be.d'isciose:d. .If continued.on e
separate sheet,.check hare:
Description-Of the Principal
Marne of Source of Income Address Bu mess AcLivity
T hereby srry affir that the aforesaid information is:e true and correct statement.
.Siariature of person.di using Dat�Signe