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Mojdeh Khaghan 12/31/2014 d A/V'�I BEACH City of Miami Beach, 1700 Convention Center Drive,Miami Beach, Florida 33139,www.miamibeachfi.gov OFFICE OF THE CITY CLERK, Rafael Granada,City Clerk Tel: (305)673-7411, Fax: (305)673-7254 Email CiyClerk @miamibeach.gov 2/11/2013 Mojdeh Khaghan 5151 Collins Ave. #1727 Miami Beach, Florida 33140 N SUBJECT s Personnel Board Congratulations! You have been reappointed by the City Commission to the above referenced agency, board or committee for a term ending: 12/31/2014. 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, Raf el E.10 City Clerk cc: Saul Frances, Parking Director Carla Gomez 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. MIAMIBEACH City of Miami Beach, 1700 Convention Center Drive,Miami Beach, Florida 33139,www.miamibeachfl.gov OFFICE OF THE CITY CLERK, Rafael Granado,City Clerk Tel: (305)673-7411, Fax: (305)673-7254 Email CityClerk @miamibeach.gov TO Mojdeh Khaghan RE: Personnel 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: 12/31/2014. 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 the Florida Commission on Ethics Guide to the Sunshine Amend- ment 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*requirements of Miami-Dade County or ithe State of Florida (depending on the board or committee on which I serve)on July 1,following the closing of the calendar year on which I have sery d. f JA I �11 M e K g ian Sworn to and subscribed before me this 7- day of &l hl,/9�,*,o,-13. Silvia Prieto Deputy Clerk *Please visit the City of Miami Beach website at www.miamibeachfl.gov under City Clerk/Board and Comm for additional information regarding the Financial Disclosure Requirement We are committed to providing excellent public service and safety to all who live, work and play in our vibrant,tropical,historic community. V l�I/ VV\ I � � ;f CITY OF MIAMI BEACH BOARD AND*MMITTEE APPLICATION FORM NAVE: Last Name First Name A41F) Middle Initial HOME ADDRESS: [JU ✓ (_.-'U1161C kT e 33NO pp��Apt No. House,No./Stretett City State Zip Code PHONE: 3oS•O�j•—ISgS 3OS•�1Z• TTT •0o1.001 rnor anrCeclL• Home Work Fax Email address Business Name: Position: Address: No. Street City State Zip Code Professional License(describe) Expires: Attach a copy of the license Pursuant to City Code section 2-22(4)a and b: Members of agencies, boards, and committees shall be affiliated with the city;this requirement shall be fulfilled in the following ways: a) an individual shall have been,a resident of the city for a minimum of six months; or b) an individual shall demonstrate ownership/interest for a minimurrrof six months;in a.-business established.in the.city.' • Resident of Miami Beach for a minimum of six(6) months:Ye0<00r No ❑ • Demonstrate an ownershipfinterest in a business in Miami Beach for a minimum of six(6) months: Yes D or No 0 • Are you a registered voter in Miami Beach:YesVor No 0 • (Please circle one): I am now a resident of: North Beach South Beach XMiddle Beach o I am applying for an appointment because I have special abilities, knowledge and experience. Please list below: •Are you presently a registered lobbyist with the City of Miami Beach?Yes 0 or No Please list your preferences in order of ranking [1]first choice [2] second choice, and [3] third choice. Pjease note that only three (3) choices will be observed by the City Clerk's Office. (Regular Boards of City) ❑Affordable Housing Advisory Committee 0 Marine Authority 0 Art in Public Places Committee .0 Miami Beach Commission for Women ❑Beautification Committee 0 Miami Beach Cultural Arts Council ❑Board of Adjustment* 0 Miami Beach Human Rights Committee ❑Budget Advisory Committee ❑Miami Beach Sister Cities Program 0 Capital Improvements-Projects Oversight Committee ❑Normandy Shores Local.Govemment Neigh. Improvement ❑Committee on the Homeless Parks and Recreation Facilities Board ❑Committee for Quality Education in MB Personnel Board ❑Community Development Advisory ❑Planning Board* 0 Community Relations Board ❑Police Citizens Relations Committee ❑Convention Center Advisory Board ❑Production Industry Council ❑'Debarment Committee ❑Public Safety Advisory Committee ❑Design Review Board* ❑Safety Committee 0 Disability Access Committee ❑Single Family Residential Review Panel 0 Fine Arts Board ❑Sustainability Committee ❑Gay, Lesbian, Bisexual and Trans ender GLB D Transportation and Parking Committee 0 Golf Advisory Committee ❑Visitor and Convention Authority ❑Health Advisory Committee 0 Waterfront Protection Committee .0 Health Facilities Authority Board ZYouth Center Advisory Board 0 Hispanic Affairs Committee ❑Historic Preservation Board 0 Housing Authority 0 Loan Review Committee *Board Required to File State Disclosure Form Note: If applying for Youth Advisory Board, please indicate your affiliation with the Scott Rakow Youth Center: �vt O TV+E !M"Z-• VP RSPH S W HO USE E&CA L.-t T14 O 1. Past service on the'Y out h Center Advisory Board; Yes�lo❑ Years of Service: _ 2. Present participation`in Youth""Cent4 activities by your'children Yes❑ No`❑.-If'yes; please list the names of your children, their ages, and which programs. List below: Child's name: Age:.. Program: Aft AM Kft Eft Aft Child's name: Age: Program: �:\'-L�-R\$ALL\a1F ORMS\BOARD AN '.OMMIT=ES\Br AppI'catior.Joc JAN 2 5 2011 1 ,T MOJDEH L. KHAGHAN 5151 Collins Avenue, Miami Beach, FL 33140 305.772.4444 . mlk @morganreed.com EDUCATION Columbia University School of Law J.D.,1991 Journal of Law&the Arts, Articles Editor Arts Law Clinic/Volunteer Lawyers for the Arts Law School Senate Parliamentarian Columbia College,Columbia University B.A.,magna cum laude, 1988 Major English Literature Ma' g Phi Beta Kappa LICENSURE The Florida Bar, United States District Court, S.D. Florida, 1995; New York State Bar, United States District Courts, S.D. and E.D. New York, 1992; New York State Real Estate Broker, 2008; Florida Real Estate Broker, 2010. EXPERIENCE Mojdeh L. Khaghan-Miami Beach, FL Attorney Practice specializing in securities litigation, trusts and estates litigation, class actions and commercial litigation. 1996 to 2007 Goodkind Labaton Rudoff&Sucharow-New York, NY Litigation Associate Concentrated in '33 and '34 Act litigation and securities class actions in federal and state courts. Handled all aspects of cases from discovery through trial and/or settlement, post- settlement distribution of recovery to clients and class members. 1992 to 1996 COMMUNITY Greater Miami Jewish Federation, 1999 to present INVOLVEMENT/ Women's Philanthropy President,2010-11,Campaign PERSONAL Chair, 2007-09; 2008 Stanley C. Myers President's Leadership Award The Vizcayans, 2004 to present Member of the Board MB Rakow Youth Center Advisory Board, 2007 to present Languages-Farsi,Spanish,French, Italian Interests-Travel,Literature, Arts&Music it MIAMI BEACH City of Miami Beach, 1700 Convention Center Drive, Miami Beach, Florida 33139, www.miamLbBachfl.gov 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) .#oBoard 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 ofthe-following with the City Clerk of Miami Beach, 17-00 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 'I,5 may subject the person-or firm to a f ne not-to exceed $500.00 or by imprisonment.-in the county jail for-a period not to exceed sixty days, or both. Signature: .Date: M I A M I•DADE SOURCE OF INCOME STATEMENT Please Print or Type First Name Middle Name/Initial Last Name Disclosure For Tax Year Name: � Ending: C�. Mailing Address: City/State/Zip: Filing as a: ® County Employee: ® Municipal Employee of: Position held or sought: Board where serving: Term or Employment Began on: Department where employed: Work Address: If your home address is exempt from public records pursuant to Florida Statutes§119.07 please check here(read instructions): ® Work Telephone: I Home Address: / , v 7 I 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 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 Source of Income Address, Business Activity I hereby swear(or a rm)that the aforesaid information is a true and correct statement. j Signa re f pe n di l ing Date sig ed