Stephen N. Zack 12/31/2014 /01AMIBEACH
City of Miami Beach, 1700 Convention Center Drive,Miami Beach, Florida 33139,www.miamibeochfI.ggy
OFFICE OF THE CITY CLERK, Rafael Granada,City Clerk
Tel: (305)673-7411, Fax: (305) 673-7254
Email CityClerk@miamibeach.gov
TO Stephen N. Zack
RE: Ad Hoc Charter Review and Revision BD
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 served.
,We'phen N.Zack
I
Sworn to and subscribed before me thisZj day of /., 2013.
A
_Z��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.
;9
M I A M I-DADE
® SOURCE OF INC®ME STATEMENT
Please Print or Type First Name Middle Name Initial Last Name
Disclosure
For Tax Year
Name: - \ Ending:
Mailing Address: no 62 FOU
City/State/Zip: "10
�• �v1 ✓ I
Social Security Number:
Filing as a: ® County Employee:
® Municipal Employee of:
Position held or sought: �VO
Board where serving: Term or Employment
I,Beegan on:
Department where employed: Boar I► ` Vl' e (' ` �rl�'l�✓l�
Work Address: ��� � e, Q Lj0 y e.
If your home address is exempt from public records pursuant to
Florida Statutes§119.07 please check here(read instructions): ® 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:
Description of the Principal
Name of Source of Income Address Business Activity
L !`
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Wo
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I hereby swear(or affirm)that the aforesaid information is a true and correct statement.