Tiffany Lapciuc 12/31/2015 � |
B �' \ ������ J~�
City of Miami Beach 170 Convention Center Drive,Miami Beach, Florida 33139,
OFFICE Df THE CITY CLERK, Rafael Granada,City Clerk
Tel: (305) 673-7411, Fox: (3O5)673-7254
2V10/2014
Tiffany Lapciuc
4900 Pine Tree Drive
Miami Beach, Florida 33140
Miami Beach Commission For Women
Congratulations! You have been reappointed b« Mayor Philip Levine
to the above naharenmyd ogency, board or committee for a term ending: 12/3112015.
If you are unable to accept this appointment' please notify the City Clerk's Office at
(3O5) 673-7411.
Please read the enclosed material carefully. Again, congratulations and good luck.
Sincerely,
Rafael E. G[@D@do
City Clerk
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ATTACHMENTS:
Letter ofAppointment
Oath
City Code Ordinance section, applicable bo agency, board orcommittee
City Code Section 2-22, 2'23, 2-24' 2'25' 2-26. 2-2458, 3-450
Ordinance 2000'3543 'Amendment to City Code Section 2-22
Miami-Dade County Code Section 2-11.1 -Conflict of Interest and Code of Ethics Ordinance
City VVide 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.
M � AM � BEACH
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
TO: Tiffany Lapciuc
i
RE: Miami Beach Commission for Women
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
have been appointed for a term ending: 12/31/2015.
I 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 Offl"cers andunderstand 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 1 st, following the closing of the calendar year on which I
have served.
01,
iffany ,a ciuc
Sworn to and subscribed before me this da y of a 14
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De u Clerk P
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*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.
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MI CE SOURCE OF INCOME STATEMENT
Disclosure for Tax Year Ending Last Name _ First Name Mid le Name/Initial
rN
Mailing Address—Street Number,Street Nalme,or P.O.Box
��fflo Dri Vt
City,State,Zip f ID Number
)�0
If your home address is Y&r 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 Board Member
❑ County Board Member Municipal Board Member, Name of Municipality: l a ) 1 &2dl
Board where serving
C;I-f-L4 bf a cS�
Work address Work telephone Term began on
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
I hereby swear(or affirm)that the information above is a true and correct statement. RECEIVED BY ELECTIONS DEPARTMENT:
❑ Hardcopy
❑ Electronic Copy
Signature o o dis ing
Print name Date signed
OFFICE USE ONLY Accepted: Y/ N Deficiency: Processed Date/Initials: Scanned Date/Initials:
138 SP-14 2/13