Yulia Laktionova Application Package
Page 1 of 6
F:\CLER\$ALL\REG\BOARD AND COMMITTEE APPLICATIONS FINAL DRAFTS\BOARD AND COMMITTEE APPLICATION REG FINAL.docx
Updated: June 2020
BOARD AND COMMITTEE APPLICATION
Last Name First Name Middle Initial
Home Address City State Zip Code
Cellular Telephone Work Telephone Home Telephone Email address
Business Name Occupation
Business Address City State Zip Code
Please list your preferences in order of ranking: [1] first choice, [2] second choice, and [3] third choice. Please note that
only three (3) choices will be observed by the Office of the City Clerk.
Ad Hoc Anti-Bullying Task Force Health Advisory Committee Normandy Shores Local Government
Neighborhood Improvement District
Advisory Council
Affordable Housing Advisory
Committee
Health Facilities Authority Board Parks and Recreational Facilities
Board
Animal Welfare Committee Hispanic Affairs Committee Personnel Board
Art in Public Places Committee Historic Preservation Board Planning Board
Audit Committee Housing Authority Police/Citizens Relations Committee
Board of Adjustment Human Rights Committee Production Industry Council
Budget Advisory Committee LGBTQ Advisory Committee Program for Public Information
Committee
Committee for Quality Education in
Miami Beach
Marine & Waterfront Protection
Authority
Senior Affairs Committee
Committee on the Homeless Mayor’s 41st Street Committee Sustainability Committee
Convention Center Advisory Board Mayor’s General Obligation Bond
Oversight Committee
Transportation, Parking, and Bicycle-
Pedestrian Facilities Committee
Cultural Arts Council Mayor’s Panel on Ocean Drive Visitor and Convention Authority
Design Review Board Miami Beach Commission for Women Youth Commission
Disability Access Committee Next Generation Council
1. _____________________________________
2. _____________________________________
3. _____________________________________
Professional License
Type of Professional License License Number
State of Issuance License Issuance Date License Expiration Date
Note: If you are seeking appointment to a professional seat (e.g. attorney, architect, etc.), you must attach a copy of your
currently effective corresponding professional license.
LAKTIONOVA YULIA
4720 PINE TREE DR #4 MIAMI BEACH FL 33140
202-374-1718 yulia.daugherty@gmail.com
NEXT GENERATION COUNCIL
ANIMAL WELFARE COMMITTEE
MIAMI BEACH COMMISSION FOR WOMEN
Page 2 of 6
F:\CLER\$ALL\REG\BOARD AND COMMITTEE APPLICATIONS FINAL DRAFTS\BOARD AND COMMITTEE APPLICATION REG FINAL.docx
Updated: June 2020
● I am applying for an appointment because I have special abilities , knowledge, and experience. Please list below:
AFFILIATION WITH THE CITY OF MIAMI BEACH
Pursuant to City Code section 2-22(4) a, b, and c: Members of Agencies, Boards, and Committees shall be affiliated
with the City. This requirement shall be fulfilled in the following ways:
a. Resident of the City for a minimum of six months: Yes or No
● I am a resident of: South Beach Middle Beach North Beach
Or
b. Demonstrates an ownership interest (for a minimum of six months) in a business established in the City (for a minimum
of six months): Yes or No
“Ownership Interest” shall mean the ownership of ten percent (10%) or more (including the ownership of 10% or more
of the outstanding capital stock) in a business.
“Business” shall mean any sole proprietorship, sponsorship, corporation, limited liability company, or other entity or
business association.
Or
c. Full-time employee of such a business (for a minimum of six months); and I am based in an office or other location of
the business that is physically located in Miami Beach (for a minimum of six months): Yes or No
Notwithstanding the requirements set forth herein, the qualified full-time employee of a business must be approved by
a 4/7th vote of the Mayor and City Commission.
NOTE: Members of Agencies, Boards, and Committees shall be required to demonstrate compliance with the City affiliation
requirements of sections 2-22 (4) a and b of the Miami Beach City Code by executing an affidavit, stipulating that they
have met either (or both) of said affiliation requiremen ts. The original affidavit shall be filed with the Office of the City Clerk
prior to being sworn in as a member.
- MEMBER OF NATIONAL PRESS PHOTOGRAPHERS ASSOCIATIN;
- INTERPETER( RUSSIAN, UKRAINIAN, ENGLISH);
- STRONG COMMUNICATION SKILLS;
- ECONOMICS;
- RESEARCH.
Page 3 of 6
F:\CLER\$ALL\REG\BOARD AND COMMITTEE APPLICATIONS FINAL DRAFTS\BOARD AND COMMITTEE APPLICATION REG FINAL.docx
Updated: June 2020
● Are you a registered active lobbyist with the City of Miami Beach? Yes or No
● Have you ever been convicted of a felony? Yes or No If yes, please explain in detail:
● Do you currently have a violation(s) of City of Miami Beach Code? Yes or No If yes, please explain in detail:
● Do you currently owe the City of Miami Beach money? Yes or No If yes, please explain in detail:
● Are you currently serving on any City Board or Committee? Yes or No If yes, which Board/Committee?
● In what organization(s) in the City of Miami Beach do you currently hold membership?
_________________________________________________________________________________________________
Name Position
_________________________________________________________________________________________________
Name Position
● List the address of all properties owned or in which you have an interest within the City of Miami Beach:
_________________________________________________________________________________________________
_________________________________________________________________________________________________
● Are you now employed by the City of Miami Beach? Yes or No If so, which department and title?
_________________________________________________________________________________________________
● Pursuant to City Code Section 2-25 (b): Do you have a parent , spouse , child brother or sister
who is employed by the City of Miami Beach? Yes or No
If “Yes,” identify person(s) and department(s):
Note: If applying for the At-Large position of the Historic Preservation Board, please answer the below questions:
• Have you ever resided in one of the City’s Historic Districts for at least one year? Yes or No
If you answered “Yes,” please indicate:
From: To
Address Dates
From: To
Address Dates
Page 4 of 6
F:\CLER\$ALL\REG\BOARD AND COMMITTEE APPLICATIONS FINAL DRAFTS\BOARD AND COMMITTEE APPLICATION REG FINAL.docx
Updated: June 2020
NOTE: IF APPOINTED, YOU WILL BE REQUIRED TO FOLLOW CERTAIN LAWS THAT APPLY TO CITY
BOARD/COMMITTEE MEMBERS. THESE LAWS INCLUDE, BUT ARE NOT LIMITED TO:
o Prohibition from directly or indirectly lobbying City personnel. (Miami Beach City Code Section 2-459)
o Prohibition from contracting with the City. (Miami-Dade County Code Section 2-11.1)
o Prohibition from lobbying before the Board/Committee you have served on for period of one year after leaving office .
(Miami Beach City Code Section 2-26)
o Requirement to disclose certain financial interests and gifts. (Miami-Dade County Code section 2-11.1)
o Sunshine Law - Florida's Government-in-the-Sunshine Law was enacted in 1967. Today, the Sunshine Law regarding
open government can be found in Chapter 286 of the Florida Statutes. These statutes establish a basic right of access to
most meetings of Boards, Commissions, and other governing bodies of state and local governmental agencies or
authorities.
o Voting conflict – Form 8B is for use by any person serving at the county, city, or other local level of government on an
appointed or elected Board, Council, Commission, Authority, or Committee. It applies equally to members of advisory and
non-advisory bodies who are presented with a voting conflict of interest under Sectio n 112.3143, Florida Statutes.
I HEREBY ATTEST TO THE ACCURACY AND TRUTHFULNESS OF THE APPLICATION ; AND I HAVE RECEIVED,
READ AND WILL ABIDE BY CHAPTER 2, ARTICLE VII, OF THE MIAMI BEACH CITY CODE, ENTITLED “STANDARDS
OF CONDUCT FOR CITY OFFICERS, EMPLOYEES AND AGENCY MEMBERS AND ALL OTHER APPLICABLE
COUNTY AND/OR STATE LAWS AND STATUTES ACCORDINGLY.”
_________________________________________________________________________________________________
Applicant’s Signature Date Name of Applicant (PLEASE PRINT)
Board and Committee Application Checklist: Please ensure you have provided all information before applying or
reapplying to any Board and Committee
□ I have answered all questions fully.
□ I have attached additional sheets, if necessary, to provide required information.
□ I have attached a current resume, photograph, and a copy of any applicable professional license.
□ I have completed and attached the Board & Committee Financial Acknowledgement Statement.
□ I have completed and attached the Diversity Statistics Report.
□ Submit complete application package.
Via Email: BC@miamibeachfl.gov
Via U.S. Mail or in Person:
City of Miami Beach
Office of the City Clerk / Board and Committee Section
1700 Convention Center Drive, 1st Floor
Miami Beach, FL 33139
If you have any questions, please contact the Office of the City Clerk via email: BC@miamibeachfl.gov or telephone:
305.673.7411.
Note: Florida Statutes §119.071: The role of the Office of the City Clerk is to receive and maintain forms filed as public
records. If your home address, telephone numbers, and/or photograph are exempt from disclosure and you do not wish
your home address, telephone numbers, and/or photograph to be made public, please: 1) Use your office or other address
for your mailing address; 2) Use your office or other telephone number for your contact number; and 3) Do not attach a
photograph.
06/30/2020 YULIA LAKTIONOVA
Page 5 of 6
F:\CLER\$ALL\REG\BOARD AND COMMITTEE APPLICATIONS FINAL DRAFTS\BOARD AND COMMITTEE APPLICATION REG FINAL.docx
Updated: June 2020
BC@miamibeachfl.gov
BOARD & COMMITTEE FINANCIAL ACKNOWLEDGEMENT STATEMENT
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)
Last Name First Name Middle Initial
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.
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;” or
2. A “Statement of Financial Interests (Form 1)1;” or
3. A Copy of your latest 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
1 Members of the Planning Board and Board of Adjustment will be notified directly by the State of Florida,
pursuant to F.S. §112.3145(1)(a), to file a Statement of Financial Interests (Form 1) with the Miami-Dade County
Supervisor of Elections by 12:00 noon, July 1. Planning Board and Board of Adjustment members who file their
Form 1 with the County Supervisor of Elections automatically satisfy the County’s financial disclosure
requirement as a Miami Beach City Board/Committee member and need not file an additional form with the Office
of the City Clerk. However, compliance with the County disclosure requirement does not satisfy the State
requirement.
LAKTIONOVA YULIA
06/30/2020
F:\CLER\$ALL\REG\BOARD AND COMMITTEE APPLICATIONS FINAL DRAFTS\BOARD AND COMMITTEE APPLICATION REG ADDENDUM.docx
Updated: June 2020
BOARD AND COMMITTEE APPLICATION
ADDENDUM
Last Name First Name Middle Initial
Signature Date
AFFILIATION WITH THE CITY OF MIAMI BEACH
Pursuant to City Code section 2-22(4) a, b, and c: Members of Agencies, Boards, and Committees shall be affiliated
with the City. This requirement shall be fulfilled in the following ways:
a. Resident of the City for a minimum of six months: Yes or No
● I am a resident of: South Beach Middle Beach North Beach
Or
b. Demonstrates an ownership interest (for a minimum of six months) in a business established in the City (for a minimum
of six months): Yes or No
“Ownership Interest” shall mean the ownership of ten percent (10%) or more (including the ownership of 10% or more
of the outstanding capital stock) in a business.
“Business” shall mean any sole proprietorship, sponsorship, corporation, limited liability company, or other entity or
business association.
Or
c. Full-time employee of such a business (for a minimum of six months); and I am based in an office or other location of
the business that is physically located in Miami Beach (for a minimum of six months): Yes or No
Notwithstanding the requirements set forth herein, the qualified full-time employee of a business must be approved by
a 4/7th vote of the Mayor and City Commission.
NOTE: Members of Agencies, Boards, and Committees shall be required to demonstrate compliance with the City affiliation
requirements of sections 2-22 (4) a and b of the Miami Beach City Code by executing an affidavit, stipulating that they
have met either (or both) of said affiliation requirements. The original affidavit shall be filed with the Office of the City Clerk
prior to being sworn in as a member.
Note: If applying for the At-Large position of the Historic Preservation Board, please answer the below questions:
• Have you ever resided in one of the City’s Historic Districts for at least one year? Yes or No
If you answered “Yes,” please indicate:
From: To
Address Dates
From: To
Address Dates
LAKTIONOVA YULIA
06/30/2020
Page 6 of 6
F:\CLER\$ALL\REG\BOARD AND COMMITTEE APPLICATIONS FINAL DRAFTS\BOARD AND COMMITTEE APPLICATION REG FINAL.docx
Updated: June 2020
Email: BC@miamibeachfl.gov
DIVERSITY STATISTICS REPORT
Last Name First Name Middle Initial
The following information is voluntary and has no bearing on your consideration for appointment. It is being
asked to comply with City diversity reporting requirements.
Gender:
Male
Female
Other
I prefer not to answer.
Race/Ethnic Categories:
What is your race?
African American/Black
Asian or Pacific Islander
Caucasian/White
Native American/American Indian
Other – Print Race:
I prefer not to answer.
Do you consider yourself to be Spanish, Hispanic, or Latino/a?
Yes
No
I prefer not to answer.
Do you consider yourself Physically Disabled?
Yes
No
I prefer not to answer this question.
LAKTIONOVA YUILIA
YULIA LAKTIONOVA
4720 Pine Tree DR
Apt #4
MIAMI BEACH, FL 33140
yulia.daugherty@gmail.com
(202)-374-1718
EXPERIENCE:
PUBLIC RELATIONS Coordinated and wrote sales/promotional material
detailing achievements and new product information.
Acted as company representative at trade shows and
exhibits. Acted as department liaison with all levels
of personnel.
COMMUNICATIONS Corresponded with customers regarding information and
shipment schedules.Handled customer complaints.
ADMINISTRATION Standardized contact filing systems for sales department.
Prepared schedules and agendas for meetings.
Developed active lead follow-up system.Maintained
Department records.Planned exhibits and trades shows.
PROFESSIONAL
PHOTOGRAPHY Greater Miami and Washington D.C. specializing mostly in
Wedding, Portrait, Commercial and Stock photography.
WORK HISTORY
2008-Present Freelance photographer
2011-2012 Splendid, INC
2012-2014 General Manager StudioCUTure, LLC
EDUCATION
2006 Linguistics
National Aviation University
Kiev, Ukraine