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Jacqueline Lalonde 12/31/2014 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: �� Endingc.��)/ Mailing Address: Al y �! ��l City/State/Zip: So dal secu'i+.. IUumbe.-. Filing as a: U County Employee: U Municipal Employee of: Position held or sought: Board where serving: ,/ �1 Term or Employm7�x Began on: lI3- . Department where employed: Work Address: If your home address is exempt from public records pursuant to Florida Statutes§119.07 ple a check here(read instructions): U Work Telephone: 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 income of your spouse or any business partner need not be disclosed. If continued on a separate sheet, check here: U Description of the Principal INAM e of Source of I ome A re usi ess Actvi d�✓ 2 e-.4 I hereby swea' (� affirm)that the aforesaid information is a true and corre statement. Signature df pers n disclosing date signed {� CiT�` CAF ��1AML,1 B E A CH BOARD AND C0l[V1.A°TTEE APPLICATION FORM NAME: Lalonde Jacqueline P Last Name First Name Middle Initial HOME ADDRESS: 1515 W 22nd Street Miami Beach FL 33140 Apt No. House No./Street City State Zip Code 305 586 2026 305 j PHONE: [7��f V Jacqueline Lalonde @raymondjames com Home Work Fax Email Address Business Name Raymond James&Associates Position: Sr.VP Investments 14 f na Address: 4fte Michigan Ave#9900 Miami Beach FL 3 139 No. Street City State Zip Code Professional License(describe): Series 7.69 etc Expires: Attac?r a cop of t:.e II'Mise 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 minimum of six months in a business established in the city. • Resident of Miami Beach for a minimum of six(6)months: Yes • Demonstrate an ownership/interest in a business in Miami Beach for a minimum of six(6)months: No •Are you a registered voter in Miami Beach: Yes • (Please circle one): I am now a resident of: South Beach • I am applying for an appointment because I have special abilities, knowledge and experience. Please list below: Current member of BAC and am applying for designated Finacial Representative within the BAC • Are you presently a registered lobbyist with the City of Miami Beach? No Please list your preferences in order of ranking [1]first choice[2] second choice, and [3]third choice. Please note that only three 3 choices will be observed by the City Clerk's Office (Regular Boards of City) Affordable Housing Advisory Committee Marine Authorit Art in Public Places Committee Miami Beach Commission for Women Board of Adjustment' Miami Beach Human Rights Committee 1 Budget Advisory Committee Miami Beach Sister Cities Program Capital Im rovements Projects Oversight Committee Normandy Shores Local Gov't Neigh. Im roveme it Committee on the Homeless Parks and Recreation Facilities Board Committee for Quality Education in MB Personnel Board CommuMy Development Advisory Planning Board' Community Relations Board Police Citizens Relations Committee Convention Center Advisory Board Production Industry Council Debarment Committee Public Safetv Advisory Committee Design Review Board' Safety Committee Disability Access Committee Single Family Residential Review Panel Fine Arts Board 8ustainability Committee Gay, Lesbian, Bisexual and Trans ender(G T) Transportation and Parkin Committee Golf Advisory Committee Visitor and Convention Authority Health Advisory Committee Waterfront Protection Committee Health Facilities Authority Board Youth Center Advisory Board Hispanic Affairs Committee Historic Preservation Board Housing Authority 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: 1. Past service on the Youth Center Advisory Board: Years of Service: 2. Present participation in Youth Center activities by your children If yes, please list the names of your chit ren,their ages, and which programs. List below: Child's name: Age: Program: Child's name: Age: Program: r_ h Have you ever been convicted of a felony: No If yes, please explain in aetaiI • Do you currently have a violation(s) of City of Miami Beach codes: No If yes, please explain in de ail: • Do you currently owe the City of Miami Beach any money: No If yes, explain in detail •Are you currently serving on any City Boards or Committees: Yes If yes; which board? BAC •What organizations in the City of Miami Beach do you currently hold membership in? Name: Title: Name: Title: • List all properties owned or have an interest in;which are Ic within, he Ciyt f Miami Beach: 1515 West 22nd street,361 Collins Ave#8 If • I am now employed by the City of Miami Beach: No Which department? • Pursuant to City Code Section 2-25(b): Do you have a who is employed by the City of Miami Beach?Check all that apply. Identify the department(s): The following information is voluntary and is neither part of your application nor has any bearing on your consideration for appointment. It is being asked to comply with federal equal opportunity reporting requirements. Gender: Female Race: Ethnic Origin: Check one only (1) White Physically Challenged: No Employment Status: Employed Other: NOTE: If appointed,you will be required to follow certain laws which apply to city board/committee members. These laws include, but are not limited to,the following: • Prohibition from directly or indirectly lobbying city personnel(Miami Beach City Code section 2-459). • Prohibition from contracting with the city(Miami-Dade County Code section 2-11.1). • Prohibition from lobbying before board/committee you have served on for period of one year after leaving office (Miami Beach City Code section 2-26). • Requirement to disclose certain financial interests and gifts(Miami-Dade County Code section 2-11.1). (re: CMB Community Development Advisory Committee): prohibition, during tenure and for one year after leaving office, from having any interest in or receiving any benefit from Community Development Block Grant funds for either yourself, or those with whom you have business or immediate family ties(CFR 570.611). Upon request,copies of these laws may be obtained from the City Clerk. "I hereby attest to the accuracy and truthfulness of the application and have received,read and will abide by Chaf iter 2, Article VII—of the City Code"Standards of Conduct for City Officers, Employees and Agency Members." I Jacqueline Lalonde agreed to the following terms on 1/11/2011 3:51:16 PM 0 Please attach a copy of yours Tesume:to this application NOTE .pPhcations:will remain on file,for a period of one(j�calendar;year: Received in the City Clerk's Office b V Date:,///!/ / Control No, Date: Name of Qeplyy Clerk 22� /� G r ] G7 O S n _ �n O tJ _ Q N ac ac o G ' T • G 'C/I <' e ^ y^ H o o j ? w o ^ y I w oy - ao aq ° as � g e r 7 O w C CD n :E In rb i �'. N i co N 1 J CD s Gl o r CO � p - - - O 61 W -a O - - a i l — 1 U1 - i':-• �,� ; _ it 'MR-1 v - � 1 i CD (-) _. ' 27 C GQ 7-T - C n c C L - -Ci C (Q _ m. :� _ - a _ n - J C' - R' Fr CY C - (n _= -_o__:_m—ro� (D - ---- - �,.o." r - - -- OL CL Cn CT- O — c cn -X. UC cn — i � O O/f _ O C - _ — O O n _ v F 12 v - O o - r - ;r7 m _ _ 77 _ G FD UJ O co Census Bureau Considers Chap` -,g Its Race/Hispanic Questions I Pew Soo.ial & Dernogr... Page 1 of 2 NUMBERS, FACTS AND TRENDS SHAPING YOUR WORLD ---------------- ........ ......................................... ...... ............ .......... PewResearch Social 8j Demographic Trends Released: August 7, 2012 Census Bureau Considers Changing Its Race/Hispanic Questions by D'Vera Cohn The Census Bureau presents new research tomorrow that attempts to address the frequent mismatch behyeen Americans'self-identity and the race or Hispanic categories they are offered on their census questionnair 0 es.The issue is especially important for counting Hispanics,the nation's largest minority group. Currently,Americans are asked separate questions about origin and race.The 2010 Census form first askdd people whether they are of Hispanic origin(and,if so,which origin).Then,all respondents were asked to check 4e or more of the boxes assigned to the five race categories(white,black,American Indian,Asian,or Hawaiian/ acific Islander).The form noted,"For this census,Hispanic origins are not races."The race and Hispanic origin�atepries 0 Z3 are set by the Office of Management and Budget,and the last major revision was in 1997• -6 NM A---WN a-M.SOW But these categories do not always match people's ideas of who they are. Despite a. P­1.1 Kwpk,Ld-.a 9ptr io'? the Census Bureau's hopes that respondents would select from the offered race categories,more than ig million people in the 2010 Census chose a catch-all Y.C- A� category,"some other race."The number and share of the population choosing some other race"grew since the 2000 Census. Most of those who chose"some other race"were Hispanic.This mismatch between the categories and the choices that Hispanics make on their census forms is growing in part because the Hispanic population is increasing rapidly.Yet government officials want people to choose from the offered categories because they are widely used,not just on the census form,but also in many federal surveys,on government forms such as school registrations,and in scientific research.Race data collected in the census are used to support enforcement of civil rights laws and redistricting of congressional districts. There also are other issues with the race categories used on the census form.For example,some respondei its objected to the word"Negro,"which was one of the choices on the 2010 Census form along with"black"or"African American."Some groups would like a separate category for those of Arab descent.There is not a specific category for the growing number of indigenous people from Latin America. Census forms through the decades have employed a changing list of race categories that reflect their times and the government did not even attempt to count Hispanics until late in the 20th century.The attempt to classify I Oeople by race or origin is by nature an imperfect enterprise.As the Office of Management and Budget acknowledge4 in 1997, 0 0 the race categories"represent a social-political construct designed for collecting data on the race and etlini, it, of broad population groups in this country,and are not anthropologically or scientifically based." http://www.pewsocialtrends.org/2012/08/07/census-bureau-considers-changing-its-racehis... 2/27/2013) 1 Census Bureau Considers Chan •g Its Race/Hispanic Questions I Pew Sonial & Demogr... Page 2 of 2 f The research to be reported tomorrow is part of a broad Census Bureau program intended to improve the iccuracy of census data.In this case,the Census Bureau experimented with alternative questionnaire design and question wording in the quest for improved responses to the race and origin questions.The research included mailing 15 a t a vPn p I� s . 2t 30,000 househ d,R c p rye V�r�uj 8v��f "ICS o. resuondents 8nd aw s etv of focus ounint ndews on th Lt;e'0 Dic o R ft-identificati GLOBAL REPORTS TOPICS INTERACTIVES DAT.ASETS BOUT A variety of changes were included on the experimental alternative questionnaires,but the-major innovati Dn tested was to combine race and Hispanic origin into a single question:"What is Person 1's race or origin?"The instructions tell respondents to mark one or more boxes.The respondent is told to write in the specific race(s)or origin(s),either as part of that question or in a second follow-up question.The bureau already has signaled that it intends o follow up with more research on this combined question. Copyright 2013 Pew Research Center Terms&Conditions Privacy Policy Feedback Careers Find an Expert http://www.pewsocialtrends.org/2012/08/07/census-bureau-considers-changing-its-racehis... 2/27/2013