Dale Stine 12/31/2014 City of Miami Beach, 1700 Convention Center Drive,Miami Beach, Florida 33139,www.miamibeachfl.gov
OFFICE OF THE CITY CLERK, Rafael Granada,City Clerk
Tel: (305)673-7411, Fax: (305)673-7254
Email CityClerk @miamibeach.gov
1/4/2013
Dale Stine
645 Michigan Ave. Apt. A
Miami Beach, Florida 33139
SUBJECT ° Gay, Lesbian, Bisexual and Transgender (GLBT)
Congratulations! You have been reappointed by Commissioner Michael G6ngora
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,
Ra ael E. G do
City Clerk
cc: Saul Frances, Parking Director
Diana Fontani
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 safe ty to all who liv e, work and play i n ou r vi bran t, tr op i ca I, historic community.
f
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 Dale Stine
RE: Gay, Lesbian, Bisexual and Transgender(GLBT)
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.
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 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 hich I hav TeStine
r
,+ D
Sworn to and subscribed before me this 1 day of ' 2013.
� G
Rjt.: Ivia 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.
A1\A I BEACH
city of Miami Beach,
1700 Convention Center Drive,
Miami Beach,Florida 33139,
www miamtbeachfLAOV ,
CITY CLERK Office CityClerkCmiarnibeachfl.gov
Tel: 305.673.741 1 , Fax: 305.673.7254
Acknowledgement of fines/.suspension for Board Mem hers 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
requiredto 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 ntt to exceed sixty
days, or.both.
Date:
signafi. re:
i
eo
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: L �L G lye Ending:
Mailing Address: 3 l� i / ► "
City/State/Zip: \CP/��1)� �'L -331 ',-16 C-) °
�� w
Filing as a: ® County Employee: ry
® Municipal Employee of:
Position held or sought: T; ry
w
Board where serving: Term or Employment -� �0
Began on: 3
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. v
Home Address: <-a- TAP-1
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 Bu 'ness Activity ,
` '1 n � •D
L
I hereby swear(or affirm)that the aforesaid information is a true and correct statement.
311Z )
Signature bt person disclosing date si ned