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Henry Lares 12/31/2013 ® MIAMI BEACH 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 02/28/2012 Henry Lares 1200 West Ave. # 817 Miami Beach, Florida 33139 SU; JE,CT Historic Preservation Board Congratulations! You have been reappointed by the City Commission to the above referenced agency, board or committee for a term ending: 12/31/2013. 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, � l Robert Parcher City Clerk cc: Saul Frances, Parking Director Thomas Mooney 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. in MIAMIBEACH 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 Henry Lares RE: Historic Preservation Board 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 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 calend r year on which I have served. n, Henry La s Sworn to and subscribed before me this day of �/ , 2012. �I- 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 piiblic•service and safety'to all who live, work and play in-our vibrant, tropical, histdric'conirriunity. MIAMI BEACH City of Miami Beoch, 1700 Convention Center Drive, Miami Beach, Florida 33139, wv+v+miomlbeochfl.aov CITY CLERK Office CityClerk@)miomlbeochfl.,gov Tel: 305.673.7411 , Fax:305.673.7254 Acknowlecigement of fines/suspension for Board Mer hers for failure to comply with Miami-Dade County Financial Disclosure Code Provision Code Section 2-11.1(i) .(2) I — LBoard Member name: understand that no later than.:iuly '1 , of each year all members of.Boards and Committees of the City of Miami Beach, including those of a purely advisory nature, :are -requiredto comply with Miami-Dade County Disclosure Requirements. -This meansthatthe 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,heve been recently appointed. You Trust 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 Bade.County Code_Chapter 1, General Provision, Section 1,5 may subject the person or firm to a f roe not to.exceed $500.00 or b imprisonment in the county}ail for a period nDt to exceed sixty days, or both r, 5 i.gnature: Dote: MI DAD ® SOURCE OF INCOME STATEME14T Please Print or Type First Name Middle Name Initial Last Name Disclosure Name: �. For Tax Year ° Ending; Mailing Address: City/State/Zip: Social Security Number: v Filing as a: ® County Employee: Municipal Employee of: Position held or sought: Vita. Board where serving Term or Employment Began on: Department where employed: Worst Address: .1f your home address.is exempt from public records pursuant to -Florida Statutes§119.07 please check here(read instructions): 0 Work Telephone: Home Address: .Street Address city State Zip Code Please list below in.descending order with the.largest source first,the name, address Ind principal .business activity of every source of your income includirig public .salary received or any person received for your benefit or.use during the disclosure period.income of your spouse or any business partner need not be disclosed. If continued separate sheet,.check here: .Description of-the Principal 'Name:of-.Source ofIncorre ` Address gassiness-Activi I :I 'ereb y swe r r affirm) that the aforesaid information is a true and correct:statement. i Signature of pe on disciosi g Date.signed I