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Aaron Perry 01/01/2014 MIAMI BEACH City of Miami Beach, 1700 Convention Center Drive,Miami Beach, Florida 33139,www.miamibeachfl.aov OFFICE OF THE CITY CLERK, Rafael Granado,City Clerk Tel: (305)673-7411, Fax: (305) 673-7254 Email CityClerk @miamibeach.gov TO: Aaron Perry RE: Charter Review 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: 01/01/2014. 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 Florida Commission on Ethics Guide to the Sunshine Amendment and Code of Ethics for Public Officers and u nd ersta n d 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 the State of Florida (depending on the board or committee on which I serve) on July 1st, following the closing of the calendar year on which I have served. Aaron Per Sworn to and subscribed before me this day of , 2013 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. I We are committed to providing excellent public service and safety to all who live, work and play in our vibrant,tropical, historic community. We ore commixed ro providing excellent public service and sofa i to all who live, work,and pia) in cur vibrant; nopicol, historic community. M AMI i SOURCE OF INCOME STATEMENT Please Print or Type First Name Middle Name Initial last Name � n � ) Disclosure Name: A-0/v For Tax Year Ending; �J� Mailing Address: City/State/Zip: Filing as a: ® County Employee: E3 Municipal Employee of: Position held or sought: Board where serving: eG7A1-Yee 4Eb/E7y/ J Term or Errspfayment Began on: � � f J7 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): 0 Work Telephone: Home Address: .Street Address Cm' 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 includiriig 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:S urce of In me Address Business-Activi i :I hereby swear (or of li at e-Oo—resaid information is a true and correct-statement. _ I i i Signature c erson disclosing Date.si.gned j