Daniel Veitia - 03/03/2015 0
MIAMIBEACH
City of Miami Beach,1700 Convention Center Drive,Miami Beach,Florida 33139,www.miamibeachfl.gov
OFFICE OF THE CITY CLERK,Rafael Granado,City Clerk
Tel:(305)673-7411,Fax:(305)673-7254
TO: Daniel Veitia
RE: Mayor's Blue Ribbon Panel on North Beach Revital
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: 03/03/2015.
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 the Florida Commission on Ethics Guide to the
Sunshine Amendment and Code of Ethics for Public Officers 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 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.
is
Sworn to and subscribed before me this -, day of 014
PI
Silvia Pri to
Deputy Clerk
*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.
We are committed to providing excellent public service and safety to all who live, work and play in our vibrant, tropical,historic community.
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MIAMI- SOURCE OF INCOME STATEMENT
Disclosure for Tax Year Ending Last Name First Name Middle Namelinitial
2013 Veitia, Daniel
Mailing Address—Street Number,Street Name,or P.O.Box
1525 Normandy Drive
City,State,Zip ID Number
Miami Beach, FL 33141
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.❑
FBing as an Employee
❑County Employee Municipal Employee,Name of Municipality:
Position held or sought
Department where employed
Work address Work telephone Term began on
1 193 71 st Street (305) 219-3408
Filling as a Board Member
❑ County Board Member ❑✓ Municipal Board Member,Name of Municipality: Miami Beach
Board where serving
North Beach Blue Ribbon Panel
Work address Work telephone Term began on
1193 71 st Street (305)403-2424 2003
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
Urban Resource 1193 71 st Street, Miami Beach, FL Property Management
117 S Shore Dr LLC 117 S Shore Dr, Miami Beach, FL Rental Property
I hereby swear(or affirm)that the information above is a true and correct statement. RECEIVED BY ELECTIONS DEPARTMENT:
❑Hardcopy
❑Electronic Copy
Signatu a on disclosing
Daniel Veitia 09104/14
Print name Date signed
OFFICE USE ONLY Accepted; Y/ N Deficiency, Processed Date/Initials: Scanned Date/lnitUs:
158_sP•14 ens
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/\AIAMI BEACH
City of Miami Beach
1700 Convention Center Drive,
Miami Beach, Florida 33139,
www.mia mi beachfl.g_o_v
CITY CLERK'S OFFICE CityClerkCmiamibeachfl.gov
Telephone: 305.673.7411 Fax: 305.673.7254
Acknowledgement of fines/suspension for Board/Committee Members for failure to comply with Miami-
Dade County Financial Disclosure Code Provision Code Section 2-11.1(i) (2)
r
Board Member's Name:
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 comply with Miami-Dade County
Financial 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 file, even
though they may have been recently appointed.
One of the following forms must be filed with the City Clerk of Miami Beach, 1700 Convention Center Drive,
Miami Beach, Florida, no later than 12:00 noon of July 1, of each year.
1. A uSource of income Statement"
For your convenience,the form is attached. The form can also be downloaded at:
http://www.miamidade.gov/elections/Librarv/source of income statement.pdf
2. A"Statement of Financial Interests (Form 1)"
For your convenience,the form is attached. The form can also be downloaded at:
http://www.ethics.state.fl.us/ethics/forms.html
3. A Copy of your 2013 Federal Income Tax Return
Failure to file one of these forms, pursuant to the Miami-Dade County Code, may subject the person to a fine
of no more than $500, 60 days in jail or both.
Signature Date
Updated:Wednesday,April 09,2014
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FXLERI$ALL\2FORMSIB0ARD AND COMMITTEMIRC APPLICATION REVISED.docx