Hortense De Castro 12.31.24f A
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BOARD AND COMMITTEE CHECKLIST
APPOINTEE: llfHnfe bOe uh -~--------------- DATE OF APPOINTMENT: pl1[23
BOARDIcoMMrrTEE: _LobTglAt Apointed y:.(ts r_(cs tn oomch
FOR SCANNER
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RECEIVED
FEB 12023
FOR CLERK STAFF
o Letter of Appointment
o Letter of Reappointment " 8$p6' ['{$" " AroommenuReasonoent e-mates to
o Board and Committee Application (Completed on 02[4 )23
o R~sum~/Curriculum Vitae ] }
o Diversity Statistics Reporting (Completed on o ] A[
o Oath
TERM END: 2]1)2} TERM uMur 2[_e l)3
Committee Liaison on
IMPORTANT INFORMATION FOR BOARD AND COMMITTEE MEMBERS BOOK
City Code Ordinance Section applicable to the agency, board or committee
City Code Sections 2-21, 2-22, 2-23, 2-24, 2-25, 2-26, 2-458 and 2-459
County Code Section 2-11.1 -- Conflict of Interest and Code of Ethics Ordinance (as
amended through December 2010)
✓Amendments to the Code of Ethics Ordinance (September 2009 through July 2012)
Highlights of the Miami-Dade County Ethics Code
Sunsh ine Law and Public Records -- Frequently Asked Questions
✓Memorandum - Solicitation by City Board and Committee Members CI TY O F MI AM I BE A CH
O FF I C E O r +LA- I T CL E R K
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Received on:
Scanned on:
o Citywide Permit Application (Parking Department Form)
o Booklet - Guide to Sunshine Amendment & Code of Ethics for Public Officers and Employees
o Source of Income Statement
o Acknowledgment of Financial Disclosure Requirement
o Board and Committees Liaison Responsibilities
o DIVERSITY STATISTICS REPORTING eep COPY in file and ORIGINAL for Annual Report.
_/b ay L,o sonea»,X Lu.. • a
7
Date oard or Committee Member
rose»sea or:_0loll23 m o ors: k/}
Date City Clerk's Office Staff Initials
_lf1.- __ l_u_1_)1.-_2 __ By Employee:----~------------
Date City Clerk's Office Staff Initials
CONCLUDED & RESIGNATION LETTERS
Term Expired Letter Date Processed Initials Scan o
Resignation Letter Date Processed Initials Scan o
Removal Letter due to absences Date processed Initials Scan o
F:\C LE R\BO A R D A ND CO M M ITT IES DA TA BA SE\CHEC K LI ST M A STER\B&C Checklist 2015 M A STER.docx
We are commiited to providing excellent public service and safety to all who live, work, and ploy in our vibrant, topical, historic community.
City of Miami Beach, !/OO Convention Canter Drive, Miami
OFFICE OF THE CITY CLERK, Raf0al E. Gran ado, Chy Clerk
Tel: 305.673.7411, Fax: 305.673.7254
Email: Cit/Clerk@miamiboochfl.gov
Florida 33139 yyy_miamnibggchll gov
January 31, 2023
Ms. Hortense De Castro
10 Venetian Way, Apt 1106
Miami Beach, Fl 33139
RE: LGBTQIA+ Advisory Committee
Dear Ms. Hortense De Castro:
Congratulations! You have been appointed by Commissioner Kristen Rosen Gonzalez to the above-
referenced Board or Committee, for a term ending: 12/31/2024.
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 as they concern your duties, responsibilities, and
requirements as a board or committee member.
Congratulations again and good luck.
" •• City Clerk
cc: Monica Beltran, Parking Director
Brian Garces, City Liaison
ENCLOSURES:
Oath of Office/Oath of Civility/Acknowledgements
City Code/Ordinance section applicable to agency, board or committee
City Code Sections 2-22, 2-23, 2-24, 2-25, 2-26, 2-458 and 2-459
Ordinance No. 2006-3543 - Am en dment to City Code Section 2-22
Miami-Dade County Code Section 2-11.1 - Conflict of Interest and Code of Ethics
City Wide Permit App lication - (Pa rking Department Form)
Booklet - Guide to the Sunshine Amendment and Code of Ethics for Public Officers and Employees
M IA MIBEACH
City of Miami Beach, I/OO Convenlion Canter Drivo, Miami Beach, Florida 33 139 yywy._miamihachll.go
OFFICE OF THE CITY CLERK, Rafael E. Granado, Ciiy Clerk
Tel 305.673.7411, Fox: 305.673.7254
Email: CilyClerk@miamibeach~fl.gov
Oath of Office
Oath of Civility
and
Acknowledgements
TO: Ms. Hortense De Castro
RE: LGBTQIA+ Advisory Committee
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: 12/31/2024.
To my colleagues and to all of those I represent and serve, I pledge fairness, integrity and civility, in all
actions taken and all communications made by me as a public servant.
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 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 1st, following the closing
of the calendar year on which I have served.
Ms. Hortense De Castro
Sworn to and subscribed before me this CJ l -"---- '+ ,2023
Keila Mena Caceres
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.
MIAMI BEACH
C ity o f Miami Beach
1 7 0 0 C onventio n C enter Drive
M ia m i Be a ch, Florid a 3 3 13 9
O FFIC E O F TH E C ITY C LERK
Email: BC@miamibeachfl.gov
Tele pho ne: 3 0 5 .6 7 3 .7 4 1 1
RECEIVED
FEB 12023
CITY OF MIAMI BEACH
OFFICE OF TE CITY CLERK
AFFIDAVIT OF AFFILIATION WITH THE CITY OF MIAMI BEACH
STATE OF FLORIDA
COUNTY OF MIAMI-DADE
I am in compliance with the affiliation requirement of Miami Beach City Code Sections 2-22 (4), as (check
(/) all that apply):
M I am a resident of the City of Miami Beach for six months or longer.
Home Address _yo lo,eta, 0,, 1\oc _ [].b_
□I have an ownership interest (for a minimum of six months) in a business established in the City of
Miami Beach (for a minimum of six months).
Name of Business. _
Business Address _
I am a full-time employee of 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).
Name or Business be Kk le ll,a.or lee ery,es bl]r]_Rally
Business Address_I/ PL,hi pa. lue. S.,A 1o5_,D @
"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.
Under pe~alt"es of perjury, I declare that I have read the foregoing document and that the facts stated in it
ar e tru e. - p p [ \ _oLc,so._._al_ 'brua v ·,I , 2 •
Signature Date
tdsc )Coto
Printed Name
NOTARY
Sworn to (or affirmed) and subscribed before me, by means of physical presence or u online notarization,
a,[a r floor (_,2o2?_y
________ (City of Miami Beach Board/Committee Member).
€?'/\\9//A/.0./.0
Produced ID
. J Form of Identification
'3'i.2. l4#$4 s7
Name of Notary, Typed, Printed, or Stamped
(NOTARY SEAL)
MIAMIB
City of Miami Beach
1700 Convention Center Drive
Miami Beach, Florida 33139
www_miamibeach[]_gov
OFFICE OF THE CITY CLERK
Email: BC@miamibeachfl.gov
Tele phon e: 305.673.7411
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:
LJ Mate
Lr em ate
D Other
Ll prefer not to answer.
Race/Ethnic Categories:
What is your race?
DI African American/Black
D Asian or Pacific Islander
[I Caucasian/white
0 Native American/American Indian Lloher- Print Race: _
DI I prefer not to answer.
Do you consider yourself to be Spanish, Hispanic, or Latino/a?
Ives
Jo
El1 prefer not to answer.
Do you consider yourself Physically Disabled?
lves 54
D I prefer not to answer this question.
Page 6 of 6
F:IC LE R \$A LLIR E G \BO A R D A N D C O M M ITT E E A P P LI C A TIO N S FIN A L D R A FTS \BO A RD A N D C O M M ITT E E A PP LI C A TIO N RE G FINA L.docx
U p dated : Ju ne 20 2 0
IAMI
City of Miami Beach
1700 Convention Center Drive
Miami Beach, Florida 33139
www.miamibeachfl,gov
OFFICE OF THE CITY CLERK
Email: BC@miamibeachfl.gov
Telephone: 305.673.7411
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)
D-Caho lAe»3
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 R equirem ents.
One of the fo llow ing fo rm s must be filed w ith the C ity C lerk of Miami Beach, 1700 Convention Center Drive,
M iam i B each, Florida, no later than 12:00 noon of July 1, of each year:
1. A "Source of Income Statement;" or v
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 m or' th an $500, 60 days in jail, or both.
lo.. •ask
Signature
lh gj
Date
L,
1 M em bers of the P lanning B oard and Board of Adjustm ent w ill be notified directly by the State of Florida,
pursuant to F.S . $112.3145(1)a). to fil e a S tatem ent of Financial Interests (Form 1) with the M iam i-D ade C ounty
S uperv isor of E lections by 12:00 noon, July 1. P lanning B oard and Board of Adjustm ent m em bers w ho file their
Form 1 with the C ounty Superv isor of Elections autom atically satisfy the C ounty's financial disclosure
re quirem ent as a M iam i Beach C ity Board/C om m ittee m em ber and need not file an additional fo rm w ith the O ffice
of the C ity C lerk. How ever, com pliance w ith the C ounty disclosure requirem ent does not satisfy the S tate
requirem ent.
Page 5 of 6
F:\C L E R \$A LL\R E G \B O A R D A N D C O M M ITT E E A P P LI C A T IO N S FIN A L D R A F T S \B O A R D A N D C O M M ITT E E A P P LI C A T IO N R E G FIN A L.do cx
Updated: June 2020
M IA M l•DA D E- EIII 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 First Name Middle Name/Initial
2022 D. Casto I lease
Mailing Address - Street Number, Street Name, or P.O. Box
70 er» th Rt tl 110
City, State, Zip I
l » ~ad .£I 33134
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. D
Filing as an Employee (check one)
[] county I] Public Health Trust [] Municipal:
(Municipality)
Department
Position or Title Employee ID Number
Work address Work telephone Employment began on/ended on
Filing as a Board Member (check one)
[] county FI Municipal: Pl l m t a
(M unicipalit y)
Board where serving
Co, thee L G 8 1 a 1 4 4Vis0R]
Alternate address (if home address is exempt) I Work telephone Term began on/ended on
30S 74-40o F bruar 202
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 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.E]
Name of Source of Income Address Description of the Principal Business Activity
Veo Yo K d,+ T2 c l
Rel+et $sh e -N ye R sh,h-st. Ny» %.o
20 1s1lad M- f « S /oo 4 R..1«ls a[
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B l s E U / RE11} /e/ tl 4 « v«
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I hereby swear (or affirm) that the information above is a true and correct statement.
At... 4.d..t
Signature of Person Disclosing
y/«4g 1, 22 >
Date signed
Rl t REC EIVED
[] Electro nic Copy
FE B 12023
CITY O F MI AM I BEACH
OFFICE OE TAE CITY CLERK
OFFICE USE ONLY Accepted: Y / N Deficiency: Processed Date/initials: Scanned Date/Initials:
138_SP-14 COE 2016