Dana Turken 12/31/2211/06/2020
Commissioner Steinberg
12/31/22 12/31/27
11/06/2020 11/06/2020
11/06/2020
Digitally Completed/DT11/13/2020
11/13/2020
11/13/2020
13th Nov
HIAHl·DADE• em SOURCE OF INCOME STATEMENT
Section 2-11.1(i) of the County Ethics Code requires that certain employees and public officials file a financial disclosure Statement on a yearly basis by July 1st of every year.
Disclosure for Tax Year Ending Last Name 1st Name
2019 ';u/J..KJ:;..,J l""-n,., Mailing Address -Street Numb�treet Name, or P.O. Box
I 0€' � 'c ,'t-; ,'° o 1 �,.,-,.<:_£ City, State, Zip 6� rY' '/'Ynf /2.P/L�.OA
:,Name/Initial
J.31:S;
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. 0
Filing as an Employee (check one)
□County □ Public Health Trust □Municipal:
(Municipality) Department
Position or Title Employee ID Number
Work address I Work telephone Employment began on/ended on
Filing as a Board Member (check one)
□County □Municipal:
(Municipality) Board where serving
�� -17n, m-/t'LW� t),9� /),,1/'M.-,1
..
Alternate address (if home address is exempt) I Work telephone ITerm began on/ended 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. Examples of sources of income include: compensation for services, income from business, gains from property dealings, interest, rents, dividends, pensions, IRA distributions, and social security payments. Also, include any source of income received by anottwr person tor your benefit. However, the income of your spouse or any business partner need not be disclosed. If continued on a separate sheet, check here.LJ Name of Source of Income Address Description of the �rincipal Business Activity
11)/ IA-
I hereby swear (or affirm) that the information above is a true and correct statement. RECEIVED BY ELECTIONS DEPARTMENT:
�d� D Hardcopy
D Electronic Copy
Signature of Person Disclosing
Date signed
OFFICE USE ONLY Accepted: Y / N Deficiency: ___________ Processed Date/Initials: ______ Scanned Date/Initials: _____ _
138_SP-14 COE 2016
X
Received November 13, 2020
Office of the City Clerk
/\t 1 Vii i 1l
City of Miami Beach
1700 Convention Center Drive
Miami Beach, Florida 33139
OF FIC E OF TH E CI TY CLERK
Em ai l:. SC@mniamibeach_gov
Telephone: 305.673.7411
AFFIDAVIT OF AFFILIATION WITH THE CITY OF MIAMI BEACH
S T A TE OF FL OR I DA
C O UN T Y OF D O é
l am in com pl iance with th e affi lia tion requirem en t of Miami B each Ci ty Code Sectio ns 2-22 (4),
as (ch eck (/) all th at apply):
[ 1a m a re si dent of th e Ci ty of Miami B each for si x m onth s or lon ger .
D I ha ve an ow nership interest (fo r a m inim um of six m onths) in a business established in the
Ci ty of M iami B each (for a mi nim um of si x m onth s).
[] 1a m a full-tim e em pl oyee of a busine ss (for a mi nim um of six m onth s) an d I am based in an
offi ce o r oth er location of th e busi ness th at is ph ysi cal ly locat ed in Miam i Beach (for a
mi ni m um of six m onth s).
"Ownership Interest" means the ownership of ten percent (10 %) or more (including the
ownership of 10% or more of the outstanding capital stock) in a business.
Business" means any sole proprietorship, sponsorship, corporation, limited liability company,
or other entity or business association.
U n der pena lties of perjury , I de cl are that I have read the foregoing docum ent and that the facts
st a ted in it are tr ue.
.-t av/A..y_,z o.o
Si gnat ure
5os ['Ky
Date
P rinted N a m e
NOTARY
S w o rn to (or affi rm ed) and subscribed befo re m e , by m eans of O physical presence or O online
.. 13th, N ovemb er not ari zation , this 'd ay of
Dana T urken (Ci ty of M iam i B each B oard/C om m ittee M em ber).
20_-by
X P ro du ced ID FL D river 's Licen se
Fo rm of Identification
p ersonally Kn own
Cao 7'get
S ign a tu re of N ot ary P ublic Charles J. D'Agóstin
N am e of N ot ary , T ype d, P rint ed, or St amp e d
(N O T AR Y SEAL)
1A!Ag,, Charles J. DAgostin ~I)~<£.:-> NOTARY PUBLIC
O - ±2.z.2°
' {e o Ts" Expires 12/14/2021