Jill Shockett 12.31.2016 MIAMIIE,kCH
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
January 30, 2015
Jill Shockett
1570 Bay Drive
Miami Beach, Florida 33141
SUBJECT: Miami Beach Commission For Women
Congratulations! You have been appointed by Commissioner Joy Malakoff to the agency,
board or committee named above for a term ending 12/31/2016.
Pursuant to City of Miami Beach Code Section 2-22 (5) a: Notwithstanding any other provision
of the City Code or of any resolution, commencing with terms beginning on or after January 1,
2007, the term of every board member who is directly appointed by a member of the City
Commission shall automatically expire upon the latter of: December 31 of the year the
appointing City Commissioner leaves office or upon the appointment/election of the successor
City Commission member.
If you are unable to accept this appointment or have any questions, please call the Office of
the City Clerk at(305) 673.7411. Please read the enclosed materials carefully. Congratulations
again, and good luck.
Sincerely,
Rafae E. ranado
City Clerk
cc: Saul Frances, Parking Director
Leonor Hernandez
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, 2-458 and 2-459
Ordinance No. 2006-3543-Amendment to City Code Section 2-22
Miami-Dade County Code Section 2-11.1 -Conflict of Interest and Code of Ethics
City Wide Permit Application-(Parking Department Form)
Booklet-Guide to the Sunshine Amendment and Code of Ethics for Public Officers and
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.miamibeachfl.aov
OFFICE OF THE CITY CLERK,Rafael Granado,City Clerk
Tel:(305)673-7411,Fax:(305)673-7254
TO: Jill R. Shockett
RE: Miami Beach Commission for Women
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: 12/31/2016.
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 Ofcersandunderstand 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 1st, following the closing of the calendar year on which I
have served.
ed/o
Ji R. Sho ett
Sworn to and subscribed before me this Al day of , 2015.
doe,.Silvia Prieto
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.
F:\CLER\$ALL\SILVIA\Oath forms\Oath.doc
We are committed to providing excellent public service and safety to all who live, work and play in our vibrant, tropical,historic community.
MIAMWADE SOURCE OF INCOME STATEMENT
COUNTY
Disclosure for Tax Year Ending Last Name First Name Middle Name/Initial
2014 S tivC ile. t'fi Ji 1I Q.
Mailing Address—Street Nu - Street Name,. •0.Box
i d lid. `:._J f_
City,State,Zip
iifiT ID Number
All IOW 33/W
If your ho• e address is your mavng addr;.s,and your home address is exempt from public records pursuant to Fla.Stat.§119.07,read
instructi.•s on the following page and check here.❑
Filing as an Employee
0 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: A--el a 117 1 1' eaot d? .
Board where serving G k i Q t ea cit ) Pi n1; 55 i o f .I-ar t.,J O rx.Qn
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.❑
ame of Source of Income Address Description of the Principal Business Activity
V ln� _/
vL �
I hereby swear(or affirm)that the information above is a true and correct statement. RECEIVED BY ELECTIONS DEPARTMENT:
❑ Hardcopy
te %/ / El Electronic Copy
4i i -
1.l 4' . ..,, ,./.0.
Signature' person d'-closing
// /7,- t} �_'-
Print name Date signed
OFFICE USE ONLY Accepted: Y / N Deficiency: Processed Date/Initials: Scanned Date/Initials:
138 SP-14 2/13
•
M1AMJ . EACH CH
City of Miami Beach
1700 Convention Center Drive,
•
Miami Beach, Florida 33139,
www.miamibeachfl.gov
CITY CLERK'S OFFICE CityClerk @miamibeachfl.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)
Board Ch.
�rd Member's Name: . i I Inc) C e.
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 "Source of Income Statement"
For your convenience, the form is attached. The form can also be downloaded at:
http://www.miamidade.gov/elections/Library/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.
-// fedif f.612 Signature
C
Date •
•
Updated:Wednesday,April 09,2014
Page 4 of 4
F:\CLER\$ALL\aFORMS\BOARD AND COMMITTEES\BC APPLICATION REVISED.docx