Dina Dissen 12/31/2014 City of Miami Beach, 1700 Convention Center Drive, Miami Beach, Florida 33139,www.miamibeachFI.aov
OFFICE OF THE CITY CLERK, Rafael Granada, City Clerk
Tel: (305)673-7411, Fax: (305) 673-7254
Email CityClerk @miamibeach.gov
12/18/2012
Dina Dissen
5030 Pine Tree Dr.
Miami Beach, Florida 33140
!SUBJECT Police Citizens Relations Committee
Congratulations! You have been reappointed by Commissioner Jerry Libbin
to the above referenced agency, board or committee for a term ending: 12/3112014.
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,
Rafael E. Granada
City Clerk
cc: Saul Frances, Parking Director
Chief R. Martinez - - - - - - - - --- --- ---- — - - - — — - --
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.
MIAMI BEACH
City of Miami Beach, 1700 Convention Center Drive,Miami Beach, Florida 33139,www.miamibeachA.gov
OFFICE OF THE CITY CLERK, Rafael Granada, City Clerk
Tel: (305)673-7411, Fax: (305)673-7254
Email CityClerk @miamibeoch.gov
TO Dina Dissen
RE: Police Citizens Relations Committee
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 I have sery
Dina Dissen
Sworn to and subscribed before me this day of 57A vt , 2012.
64Q F V t 0 0
Silvia Prietov
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 pfoviding excellent public service and safety to all who live, work and play in our vibrant tropical, historic community. e%
MIAMI BEACH
city of Miami Beach,
1700 Convention Center Drive,
Miami Beach, Florida 33139,
www miam(beochfl.pov
CITY CLERK Office CityClerk @miamibeachfl.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)
Board Member name: D 1;lm D/ 54; F At
understand that no later than July I, of -each year all members of.Boards and
Committees of the .City of Miami Beach, includirl_g 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 ffle,:even-though you may have..been
recently appointed.
You must file one ofthe 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 f ne not-to exceed
.$500.00 or by imprisonment'in the county.jail for a period not to exceed sixty
days, or both.
Date:
Signature: