Jill Tavlin Swartz 06/30/2014 PTA Rep .M I AM B E AC
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
April 23, 2013
Jill Tavlin Swartz
6081 North Bay Road
Miami Beach, FL 33140
SUBJECT: Committee For Quality Education In Miami Beach
Congratulations! You have been appointed as a Representative of the PTA for
Beach High Elementary to the above Agency, board or committee for a term
ending 06/30/2014.
If you are unable to accept this appointment, please notify the City Clerk's Office
at (305) 673-7411 .
Sincerely,
1
Rafael E. Granado
City Clerk
cc: Leslie Rosenfeld, Liaison
Saul Frances, Parking Director
We are committed to providing excellent public service and safety to all who live, work and play in our vibrant, tropical, historic community.
MIAMIBEACH
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 CiyClerk @miamibeach.gov
TO Jill Tavlin Swartz
RE: Committee For Quality Education In Miami Beach
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: 6/30/2014.
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.
L I 6j&4wjc �
��Jill Tavlin Swart
Sworn to and subscribed before me this `U'dll�ay of F , 2013.
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 sery ice 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.miomi beach A.00v
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 2-1 1.1(i) (2)
Board Member name: a l&_ 1�a i/ u*z �&M RrZ
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
required to complywith Miami-Dade County Disclosure Requirements. This means thatthe
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, 2010.
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 not to exceed sixty
days, or both.
K-1%
Sign ure` Date:
MIMI®' SOURCE OF INCOME STATEMENT
Disclosure for Tax Year Ending Last ame First Name Middle Name/Initial
�d v ��a� 3 i 1 TM
Mailing Address—Street Number,Street Name,or P.O.Box
�oql h �a
City,State,Zip ID Number
M i(A,VVI 1 �Ua-CtI F. 331+D
If your home address is your mailing address,and your home address is exempt from public records pursuant to Fla.Stat.§119.07,read
instructions on the following page and check here.
Filing as an Employee
❑County Employee Municipal Employee,Name of Municipality:
Position held or sought
Department where employed
Work address Work telephone Term began on
Filing as a hoard Member
County Board Member unicipal Board Member, Name of Municipality: tom( CA Ck,
Board where serving
Lpwlwuze.�
Work address Work telephone Term began on
3-:5 SID ry-�I G AA'( A-j R, U l t i 331 y-o H'a;-z400 G 1�o 0
List below every source of income you received,along with the address and the principal activity of each source.Include your public salary.Place
the sources of income in descending order,with the largest source first.Also, include any source of income received by another person for your
benefit.However,the income of your spouse or any business partner need not be disclosed. If continued on a separate sheet,check here.❑
Name of Source of Income Address Description of the Principal Business Activity
D t Of Ruin Q utr1d. � �3'� �u� i'11ta� I �v� Q 2v1 u CpUtv�Sel
I hereby swear(or affirm)that the information above is a true and correct statement. RECEIVED BY ELECTIONS DEPARTMENT:
❑ Hardcopy
❑ Electronic Copy
Signatu of person disclosing
j-,1\ `TMl � n
Print name Date signed
OFFICE USE ONLY Accepted: Y/ N Deficiency: Processed Date/Initials: Scanned Date/Initials:
138 SP-14 2/13