06_01_2010 Financial Disclosure Package

Embed Size (px)

Citation preview

  • 8/7/2019 06_01_2010 Financial Disclosure Package

    1/27

    CITY OF MIAMI, FLORIDAINTER-OFFICE MEMORANDUM

    TO : Al l Chiefs and Depar tment DATE ' May 27 , 2010 FlLE .DirectorsSUBJECl Financial Disclos ur e RE :Ci ty Officials/A dv i so ry

    Board Members /Muni c ipalE mployee s Requ ire mentsFROM REFERENCESMichelle P in a, Ph.D., D r t . i o n s

    ENCLOSURESDN:er:;:c::;RCTh e "Code of E thics for Public Officers and Employees, " adopt.ed by th e Legislature,is fo und in Cha pter 11 2 (Part III) of the Florida Statutes. Th e Mia mi Dade CountyConflict of In teres t and Ethics Ordinance is found in Section 2-1l.1 , of the Mi amiDade County Code. Th ese codes are intended to ensure that. public officia ls a nde mployees cond uct th emse lves independently and impartially, no t us in g th ei r officesfor private ga in oth er t.han compensation provided by law. Th is serves to remindyou that the deadline for filing financial disclosure is July 1, 2010. A graceperiod is provided until Sept.ember 1"t of each year. Also in accordance with filingthe financial disclosure an d as amended in Chapter 2, Section 2-:38 of the CityOrdinance, The l'vlayor, City Commissioners, City Man ager, Chi ef of Operations ,Chi ef Financial Officer, Chief Information Officer, Chief of Fire, Chief of Police,Department Di rec tors or those with equivalent positions , Executive DirectOl'oS ofboards or com mi ttees and all appointed board members are requil'ed to havecomple ted a n e thics course within ninety (90) days of taking office or withina t least one (1) year prior to t a king office or employment. Th e l'vIiami-DacleCommiss ion on E thics and Public Trust and Supervisor of Elections a re required tocertify after tha t time the names an d positions held by persons who fail to file byth e end of the grace period. Additionally, any pe rson in violation of completin g thee th ics course shall be subject to the penalties provided in Section 1-13 of theOrdinance. The di sclosure laws summarized below apply generally to al l publicofficers and employees, including members of advisory boards. We also s uggest thatyou reVlew t he wording of the actual law. Citations to appropriate law s are inbrackets.A. F ORM 1 - STATEME NT OF FINANCIAL IN TERESTS 2009 (SEE

    AP PEND IX A)1. Who is required to fi le FORM 1:

    Public Officers and Employees serving the City of Mi a mi required tofile FO RM 1 include a ny person meeting the definition of "localoftlce r" provided for under state s tatute.A "local o fficer" is described in 11 2.3145(a), F.S., to mea n:

    http:///reader/full/adopt.edhttp:///reader/full/adopt.ed
  • 8/7/2019 06_01_2010 Financial Disclosure Package

    2/27

    All Chiefs and Department DirectorsMa y 27,2010Page 2 of 11

    1. Every person who is elected to office in any politicalsubdivision of the state, and every person who is appointed tofill a vacancy for an unexpired term in such an elective office.

    11. Any appointed member of any of th e following boards,councils, commissions, authorities, or other bodies of anycounty, municipality, school district, independent specialdistrict, or other political subdivision of the state:a. The governing body of the political subdivision,

    if appointed;

    b. An expressway authority or transportation authority established by general law;

    c. A community college or junior college district board of trustees;

    I

    d. A board having the power to enforce local code prOVISIOns;

    e. A planning or zoning board, board of adjustment, boardof appeals, or other board having the power torecommend, create, or modify land planning or zoningwithin th e political subdivision, except for citizenadvisory committees, technical coordinatingcommittees, and such other groups who only have thepower to make recommendations to planning or zoningboards;

    f. A pension board or retirement board having the powerto invest pension or retii'ement funds or th e power tomake a binding determination of one's entitlement to oramount of a pension or other retirement benefit; or

    g. Any other appointed member of a local governmentboard who is required to file a statement of financialinterests by the appointing authority or the enablinglegislation, ordinance, or resolution creating the board.

    111. Any person holding one or more of the following positions: mayor;county or city manager; chief administrative employee of a county,municipality, or other political subdivision; county or municipalattorney; chief county or municipal building code inspector; countyor municipal water resources coordinator; county or municipalpollution control director; county or municipal environmental

  • 8/7/2019 06_01_2010 Financial Disclosure Package

    3/27

    All Chiefs an d Department DirectorsMa y 27,2010Page 3 of 11

    control director; county or municipal administrator, with power togrant or deny a land development permit; chief of police; fire chief;municipal clerk; district school superintendent; community collegepresident; district medical examiner; or purchasing agent havingth e authority to make any purchase exceeding th e threshold amountprovided in 287.017, F.S., for CATEGORY ONE, on behalf of anypolitical subdivision of the state or any entity thereof.

    In accordance with the above referenced statutorydefinition, persons required to file FORM 1, includepublic officers and employees holding the followingspecific titles and/or positions in the City of Miami: Honorable Mayor & Members of the City Commission and any

    person appointed to fill a vacancy in such office City Manager City Attorney City Clerk Auditor General Chief of Strategic Planning, Budgeting and Performance Chief of Operations Chief Financial Officer Chief Information Officer Deputy Chief Administrator Any Chief Administrative Employee Fire Chief Police Chief Director, Code Enforcement Municipal Administrator with the power to gl'ant or deny a land

    development permit Director, Building Zoning Administrator Director, Planning Purchasing Agents (regardless of the title) having the authority to

    make any purchase exceeding $15,000 for th e City or any entitythereof: this rnay include:Executive Director, Miami Sports and Exhibition Authority Executive Director, Bayfront Park Management Trust Executive Director, Downtown Development Authority Executive Director, Virginia Key Beach Park Trust PresidentlCJBO, Liberty City Community Revitalization Trust Executive Director, Department of Off Street Parking

    Additionally, persons required to file FORM 1, include membersof the following Authorities, Boards & Trusts:

  • 8/7/2019 06_01_2010 Financial Disclosure Package

    4/27

    All Chiefs and Department Dil'ectol'sMa y 27,2010Page 4 of 11

    Code Enforcement Board Fire Fighters/Police Retirement Trust General/Sanitation Employees Retirement Trust Planning Advisory Board Zoning Board Historic and Environmental Preservation Board

    2. What information is required to be disclosed in FORM 1 andwhere can you obtain a copy of FORM 1:FORM 1 requirements are set forth fully in the form, The disclosureperiod reflects your financial interests for the preceding tax year,whether based on a calendar year or on a fiscal year. You may obtain acopy of FORM 1 STATEMENT OF FINANCIAL INTERESTS 2009from your department director or the City Clerk. Alternatively, FORM'1 an d instructions on how to complete and file said form can be found at

    3. Where to file FORM 1:City of Miami public officers or employees described above are requiredto file FORM 1 STATEMENT OF FINANCIAL INTERESTS 2009with the Supervisor of Elections in the County in which he or shepermanently resides. For those Public' Officers and Employeespermanently residing in Miami-Dade County, FORM 1 must be filedwith the MIAMI-DADE COUNTY SUPERVISOR OF ELECTIONS asfollows:

    I f by mail, please address to:

    I f by hand, please deliver to:

    4. Penalties:

    Lester SolaMiami-Dade County Supervisor of ElectionsElections DepartmentP.O. Box 521550Miami, Florida 33152-1550Lester SolaMiami-Dade County Supervisor of ElectionsElections Department2700 N.W. 87 AvenueDoral, Florida 33172

    Public officers, candidates for public office, or public employees requiredto file FORM 1 annual disclosure are subject to automatic fines of $25

  • 8/7/2019 06_01_2010 Financial Disclosure Package

    5/27

    All Chiefs an d Depaxtment DirectorsMay 27,2010Page 5 of 11

    for each day late the form is filed after September 1st, up to amaximum fine of $1,500. [Section 112.3145, F. S.]A failure to make any required disclosure constitutes grounds for andmay be punished by one or more of the following: disqualification frombeing on the ballot, impeachment, removal or suspension from office oremployment, demotion, reduction in salary, reprimand, or a civilpenalty not exceeding $10,000. [Sec 112.317, F. S.]

    Any inquiries regarding appeals of fines should be directed to the MiamiDade County Commission on Ethics an d Public Trust at (305) 579-2594;

    For additional information please review thelanguage contained in the Code of Ethics for Public Officers and Employeesfound in Part III of Chapter 112, Florida Statutes [Section 112.3145, F. S.].

    B. SECTION 2-11.1., MIAMI-DADE COUNTY CODE; "MIAMI DADECOUNTY CONFLICT OF INTEREST AND CODE O:F ETHICSORDINANCE."Public officers and employees serving the City of Miami are also subject tothe disclosure requirements se t forth in the Miami-Dade County Conflict ofInterest and Code of Ethics Ordinance. Section 2-11.1 of the Miami-DadeCounty Code constitutes a minimum standard of ethical conduct an dbehavior for all municipal officials and officers, autonomous personnel,quasi-judicial personnel, advisory personnel, departmental personnel andemployees of municipalities in the County insofar as their individualrelationships with their own municipal governments are concerned.References in Section 2-11.1 to County personnel is applicable to municipalpersonnel who serve in comparable capacities to the County personneldescribed in said ordinance.1. \Vho is required to file financial disclosure under the

    MIAMI-DADE COUNTY CODE OF ETHICS: Assistant City Attorneys Deputy City Attorneys Assistant Directors or Deputies Assistant Police Chiefs Department Directors Deputy Directors Deputy Police Chief Police Majors Police Captains Zoning Inspectors Building Inspectors

  • 8/7/2019 06_01_2010 Financial Disclosure Package

    6/27

    All Chiefs an d Department DirectorsMay 27,2010Page 6 of 11

    Any architect, professional engineer, landscape architect orregistered land surveyor performing services for City of Miami, itsagencies or instrumentalities pursuant to a contract

    Additionally" persons required to file financial disclosure underthe County code of Ethics, include:All members of semi-autonomous authorities, boards and agencies as areentrusted with the day to day policy setting, operation and managementof certain City functions or areas of responsibilIty, even though theultimate responsibility for such functions or areas rests with the CityCommissioner's;All members of boards that perform "quasi-judicial" functions; andAll members of boards and agencies whose sole or primary responsibilityis to recommend legislation or give advice to the City Commission.In accordance with the provisions of the above cited county codesection, persons subjected to the Miami-Dade County Code ofEthics financial disclosure requirement include members of thefollowing City of Miami boards, authorities, agencies, and trusts: Arts & Entertainment Council Audit Advisory Committeeo Bayfront Park Management Trust Civil Service Board Civilian Investigative Panel Coconut Grove Business Improvement District (BID) Board Code Enforcement Board Commercial Solid Waste Management Advisory Committee Commission on the Status of Women Community Relations Board Community Technology Advisory Board District 1 Housing Advisory Board Downtown Development Authority Education Advisory Board Equal Opportunity Advisory Board Finance Committee Fire Fighters/Police Retirement Trust General Sanitation Employees Retirement Trust Health Facilities Authority Board Historic & Environmental Preservation Homeland Defense/Neighborhood Improvement Bond Program

    Oversight Board Housing and Commercial Loan Committee Liberty City Community Revitalization Trust

  • 8/7/2019 06_01_2010 Financial Disclosure Package

    7/27

    All Chiefs and Department DirectorsMay 27,2010Page 7 of 11

    Mayor's International Council Miami Sports an d Exhibition Authority Midtown Community Redevelopment Agencyo Nuisance Abatement Board OAB/Overtown Community Oversight Board Off Street Parking Board Parks and Recreation Advisory Board Planning Advisory Board SEOPW and OMNI Community Redevelopment Agencies Urban Development Review Boardo Virginia Key Beach Park Trust

    ' . Waterfront Advisory Board Zoning Board

    2. What form of financial disclosure is required by MIAMI- DADECOUNTY and when must you file:All persons described above shall file, no later than 12:00 noon of July1, 2010 and thereafter each year including the July 1s t following the lastyear that person is in office or held such employment, one (1) of thefollowing:A copy of that person's or firm's current federal income taxreturn;orA current certified financial statement on a form of the typeapproved fo r use by State or national banks in Florida listing allassets and liabilities having a value in excess of one thousanddollars ($1,000.00) and a shor t description of each;orAn itemized "Source of Income Statement", under oath and on aform approved by the County for said purpose. (SEE APPENDIXB)

    Please refer to the Adrninistratiue Policy M a ~ u a l (APM) 2-08 for the City ofMiami's Policy on Social Security nwnbers.

    fiNote: Compliance with the financial disclosure provisions of Part III,Chapter 112, Florida Statutes, as amended, constitutes compliancewith th e financial disclosure requirement under the Miami-DadeCounty Code of Ethics. Thus, filing FORM 1 STATEMENT OFFINANCIAL INTERESTS (see section A, above) automatically satisfies theMiami-Dade County Code of Ethics financial disclosure requirements.

    http:///reader/full/1,000.00http:///reader/full/1,000.00
  • 8/7/2019 06_01_2010 Financial Disclosure Package

    8/27

    All Chiefs and Department DirectorsMay 27,2010Page 8 of 11

    However compliance with the County's disclosure requirement does notsatisfy the State requirement. More specifically, if you are a person that isincluded in both sections A and B, you must file FORM 1 STATEMENT OFFINANCIAL INTERESTS. After such filing, an d submission of a copy ofFORM 1 STATEMENT OF FINANCIAL INTERESTS to the City Clerk,you are considered to have satisfied the Miami-Dade County Code of Ethicsfinancial disclosure requireinents.3. Where to file_ the financial disclosure required by MIAMI-DADE

    COUNTY CODE OF ETHICS:The above cited financial disclosure forms must be filed with the MIAMICITY CLERK as follows:

    I f by mail, please address to: Priscilla A. Thompson, CMC, City ClerkCity Clerk's OfficeP.O. Box 330708Miami, Florida 33233-0708

    I f by hand, please deliver to: Priscilla A. Thompson, CMC, City ClerkMiami City Hall3500 Pan American DriveMiami, Florida 33133

    C. STATE OF FLORIDA AND MIAMI-DADE COUNTY REQUIREMENTFOR REPORTING GIFTS (ANNUAL AND QUARTERLY FILING)1. Other forms that you need to file in order to comply with the

    ethics laws include:(i) FORM 9 - QUARTERLY GIFT DISCLOSURE (SEE APPENDIXC)

    Each person required to file FORM 1 STATEMENT OFFINANCIAL INTEREST or required to file financial disclosureunder the Miami-Dade County Code of Ethics, as more specificallydescribed in Sections A and B, must file FORM 9 entitled:"Quarterly Gift Disclosure." FORM 9 must be filed with th eCommission on Ethics by the end of the calendar quarter (March 31,June 30, September 30, December 31) following the calendarquarter in which the gift worth over $100 (other than gifts fromrelatives, gifts prohibited from being accepted, gifts primarilyassociated with his or her business employment, and gifts otherwiserequired to be disclosed) was received. [Sec. 112.3148, F. S. andMiami-Dade County Code Section 2-11.1(e)]

  • 8/7/2019 06_01_2010 Financial Disclosure Package

    9/27

    All Chiefs and Department DirectorsMay 27,2010Page 9 of 11

    (ii) FORM 10-ANNUAL DISCLOSURE OF GIFTS FROMGOVERNMENTAL ENTITIES AND DIRECT SUPPORTORGANIZATION S AND HONORARIUM EVENT RELATEDEXPENSES (SEE APPENDIX D)State government entities, airport authorities, counties, municipalities,school boards, water management districts, th e Tri-County CommuterRail Authority, and the Technological Research and DevelopmentAuthority may give a gift worth over $100 to a person required to fileFORM 1 or FORM 6, and to State procurement employees, if a publicpurpose can be shown for th e gift. Also, a direct-support organization fora governmental entity may give such a gift to a person who is an officeror employee of that entity. These gifts are to be reported on FORM 10,to be filed by July 1, 2010.

    The governmental entity or direct-support organization giving th e gift mustprovide the officer or employee with a statement about th e gift no later thanMarch 1st of th e following year. The officer or employee then must disclosethis information by filing a statement by July 1, 2010 with his or her annualfinancial disclosure that describes the gift an d lists the donor, th e date of thegift, an d the value of th e total gifts provided during th e calendar year. Stateprocurement employees file their statements with the Commission on Ethics.[Sec. 112.3148, F. S.]In addition, a person required to file FORM 1, who receives expenses orpayment of expenses related to an honorarium event from someone who isprohibited from giving him or her an honorarium, must disclose annually thename, address, and affiliation of th e donor, th e amount of the expenses, thedate of the event, a description of the expenses paid or provided, and thetotal value of th e expenses on FORM 10. The disclosure must be. filed byJuly 1, 2010, for expenses received during the previous calendar year, withthe officer's or employee's FORM 1. [Sec. 112.3148 and 112.3149, F. S.]2. Where to file FORM 9 AND FORM 10:

    Public officers and employees who are required to file FORM 9 and/orFORM 10 file with:

    Florida Commission on EthicsP.O. Drawer 15709Tallahassee, FL 32317-5709

    Public officers an d employees who are required to file FORM 9 and/orFORM 10 are also required to comply with the Miami-Dade CountyCode of Ethics gift disclosure requirement. [Miami-Dade County

  • 8/7/2019 06_01_2010 Financial Disclosure Package

    10/27

    All Chiefs and Department DirectorsMay 27,2010Page 10 of 11

    Code of Ethics Ordinance, Sec. 2-11.1(e)] Said disclosure shall be, made by filing a of the disclosure FORM 9 and/or FORM 10 with:)I f by mail, please address to: Priscilla A. Thompson, CMC, City Clerk

    City Clerk's OfficeP,O, Box 330708Miami, Florida 33233-0708

    I f by hand, please deliver to: Priscilla A. Thompson, CMC, City ClerkMiami City Hall3500 Pan American DriveMiami, Florida 33133

    D. OUTSIDE EMPLOYMENT STATEMENT (SEE APPENDIX E)All full-time municipal employees who engage in outside employment for anyperson, firm, corporation or entity other than the City of Miami or any otherof its agencies or instrumentalities, must file annually, under oath, astatement indicating the source of the outside employment, th e nature of thework performed, and an y amounts or type of money or other considerationreceived by th e employee from th e outside employment. [Miami-DadeCounty Code Section 2-11.1.(k)]The completed Outside Employment Statement form must be filed withth e CITY OF MIAMI CITY CLERK by July 1,2010.Send your completed and signed form to:I f by mail, please address to: Priscilla A. Thompson, CMC, City Clerk

    City Clerk's OfficeP.O. Box 330708Miami, Florida 33233-0708

    I f by hand, please deliver to: Priscilla A. Thompson, CMC, City ClerkMiami City Hall3500 Pan American DriveMiami, Florida 33133

    E. AVAILABILITY OF FORMS; FOR'MORE INFORMATION:Copies of all forms referenced herein are attached in Appendices Athrough E. Department directors are asked to reproduce as many copies ofth e forms as are required to accommodate staff needs. Additionalinformation about the state requirements may be found in Chapter 34 of th eFlorida Administrative Code. Copies of these forms and additionalinformation about the interpretation of these laws are available from the

  • 8/7/2019 06_01_2010 Financial Disclosure Package

    11/27

    All Chiefs and Department DirectorsMay 27,2010Page 11 of 11

    City of Miami City Clerk, and the Florida Commission on Ethics website:wWtc.ethics.state./1.l1s.

    I f you have any questions concerning this subject, please call the Office ofthe City Clerk at (305) 250-5360.

    Enclosure(s)

    c: Priscilla A. Thompson,CMC, City Clerk

  • 8/7/2019 06_01_2010 Financial Disclosure Package

    12/27

    APPENDIX A FORM! STATEMENT OF 2009

    Please print or type your name, mailing Iaddress, agency name, and position below: FINANCIAL INTERESTS ILAST NAME -- FIRST NAME -- MIDDLE NAME: FOR OFFICEUSE ONLY:MAILING ADDRESS:

    ID Code

    CITY. ZIP: COUNTY:ID No.

    NAME OF AGENCY: Conf. CodeNAME OF OFFICE OR POSITION HELD OR SOUGHT: P Req. Code

    You are not limited to the space on the l ines on this form. Attach additional sheets, if necessary.CHECK ONLY IF D CANDIDATE OR D NEW EMPLOYEE OR APPOINTEE

    "BOTH PARTS OF THIS SECTION MUST BE COMPLETED"DISCLOSURE PERIOD:THIS STATEMENT REFLECTS YOUR FINANCIAL INTERESTS FOR THE PRECEDING TAX YEAR, WHETHER BASED ON A CALENDAR YEAR OR ONA FISCAL YEAR. PLEASE STATE BELOW WHETHER THIS STATEMENT IS FOR THE PRECEDING TAX YEAR ENDING EITHER (check one):

    D DECEMBER 31, 2009 OR D SPECIFY TAX YEAR IF OTHER THAN THE CALENDAR YEARMANNER OF CALCULATING REPORTABLE INTERESTS:THE LEGISLATURE ALLOWS FILERS THE OPTION OF USING REPORTING THRESHOLDS THAT ARE ABSOLLJTE DOLLAR VALUES, WHICHREQUIRES FEWER CALCULATIONS, OR USING COMPARATIVE THRESHOLDS, WHICH ARE USUALLY BASED ON PERCENTAGE VALUES (seeinstruct ions for further details). PLEASE STATE BELOW WHETHER THIS STATEMENT REFLECTS EITHER (check one):0 COMPARATIVE (PERCENTAGE) THRESHOLDS OR D DOLLAR VALUE THRESHOLDSPART A -- PRIMARY SOURCES OF INCOME [Major sources of income to the reporting person](If you have nothing to report, you must write "none" or "n/a")

    NAME OF SOURCE SOURCE'S DESCRIPTION OF THE SOURCE'SOF INCOME ADDRESS PRINCIPAL BUSINESS ACTIVITY

    PART B SECONDARY SOURCES OF INCOME [Major customers, clients, and other sources of income to businesses owned by the reporting person](If you have nothing to report, you must write "none'; or "n/a")NAME OF NAME OF MAJOR SOURCES ADDRESS PRINCIPAL BUSINESSBUSINESS ENTITY OF BUSINESS' INCOME OF SOURCE ACTIVITY OF SOURCE

    PART C REAL PROPERTY [Land, buildings owned by the reporting person] FILING INSTRUCTIONS fo r(If you have nothing to report, you must write "none" or "n/a") when and where to file this formare located at the bottom of page 2.INSTRUCTIONS on wh o mustfi le this form an d how to f ill it ou tbegin on page 3.OTHER FORMS you may needto fi le ar e described on page 6.

    CE FORM 1 - Eft. 112010 (Continued on reverse side) PAGE 1

  • 8/7/2019 06_01_2010 Financial Disclosure Package

    13/27

    PART D INTANGIBLE PERSONAL PROPERTY [Stocks, bonds, certificates of deposit, etc.](If you have nothing to report, you must write "none" or "n/a")

    TYPE OF INTANGIBLE BUSINESS ENTITY TO WHICH THE PROPERTY RELATES

    PART E LIABILITIES [Major debts](If you have nothing to report, you must write "none" or "n/an )

    NAME OF CREDITOR ADDRESS OF CREDITOR

    PART F -INTERESTS IN SPECIFIED BUSINESSES [Ownership or positions in certain types of businesses](If you have nothing to report, you must write "none" or "n/a")BUSINESS ENTITY # 1 BUSINESS ENTITY # 2 BUSINESS ENTITY # 3

    NAME OF BUSINESS ENTITYADDRESS OF BUSINESS ENTITYPRINCIPAL BUSINESS ACTIVITYPOSITION HELD WITH ENTITYI OWN MORE THAN A 5%INTEREST IN THE BUSINESSNATURE OF MYOWNERSHIP INTEREST ,IF ANY OF PARTS A THROUGH F ARE CONTINUED ON A SEPARATE SHEET, PLEASE CHECK t:\ERE DSIGNATURE '(required): DATE SIGNED (required):

    FILING INSTRUCTIONS:WHAT TO FILE: WHERE TO FILE: WHEN TO FILE:After completing all parts of this form, including .If you were mailed the form by the Commission Initially, each local officer/employee, state'signing and dating it, send back only the first on Ethics or a County Supervisor of Elections for officer, and specified state employee mustsheet (pages 1 and 2) for filing, your annual disclosure filing, return the form to file within 30 days of the date of his or herthat location. appointment or of the beginning of employ-If you have nothing to report in a particular Local officers/employees file with the Supervisor ' ment. Appointees who must be confirmed bysection, you must write "none" or "n/a" in that of Elections of the county in which they perma the Senate must file prior to confirmation, evensection(s). nently reside. (If you do not permanently reside if that is less than 30 days from the date of theirin Florida, file with the Supervisor of the county appointment.Facsimiles will not be accepted. where your agency has its headquarters.) Candidates for publicly-elected local officeNOTE: State officers, or specified state employees must file at the same time they file theirMULTIPLE FILING UNNECESSARY: file with the Commission on Ethics, P.O, Drawer qualifying papers,Generally, a person who has filed Form 1 for a 15709, Tallahassee, FL 32317-5709; physical Thereafte;, local officers/employees, statecalendar or fiscal year is not required to file a address: 3600 Maclay Boulevard, South, Suite Officers, and specified state employees aresecond Form 1 for the same year. However, a 201, Tallah.assee, FL 32312, required to file by July 1 st following eachcandidate who previously filed Form 1 because Candidates. file this form together with their calendar year in which they hold their posiof another public position must at least file a copy qualifying papers. ' tions:of his or her original Form 1 when qualifying. To determine what category your position Finally, at the end of office or employment,falls under, see the "Who Must .File" Instructions each local officer/employee, state officer, andon page 3. specified state employee is required to file afinal disclosure form (Form 1F) within 60 days

    of leaving office or employment.CE FORM 1 - Eff. 1/2010 PAGE 2

  • 8/7/2019 06_01_2010 Financial Disclosure Package

    14/27

    INSTRUCTIONS FOR COMPLETING FORM 1STATEMENT OF FINANCIAL INTERESTS

    WHO MUST FILE FORM 1:All persons who fall within the categories of "state officers," "local officers/employees," "specified state employees," as well as candidates for elective local officeare required to file Form 1. Positions within these categories are listed below. Persons required to file full financial disclosure (Form 6) and officers of the judiciaibranch do not file Form 1 (see Form 6 for a list of persons who must file that form).STATE OFFICERS include the following positions for state officials:1) Elected public officials not serving in a political subdivision of the state

    and any person appOinted to fill a vacancy in such office, unless required tofile full disclosure on Form 6.2) AppOinted members of each board, commission, authority, or councilhaving statewide jurisdiction, excluding members of sole adviSOry bodies;but including judicial nominating commission members; Directors of theFlorida Black Business Investment Board, Enterprise Florida, Scripps FloridaFunding Corporation, Workforce Florida, and Space Florida; Members of theFlorida Commission on Tourism, Florida Substance Abuse and Mental HealthCorporation, and the Council on the Social Status of Black Men and Boys; andGovernors and senior managers of Citizens Property Insurance Corporationand Automobile Joint Underwriting Association. .3) The Commissioner of Education, members of the State Board ofEducation, the Board of Governors, and the local Boards of Trustees andPresidents of state universities.LOCAL OFFICERS/EMPLOYEES i n c l ~ d e the following positionsfor officers alJd employees of local government:1) Persons elected to office in any political subdivision (such as munici

    palities, counties, and special districts) and any person appOinted to fill avacancy in such office, unless required to file full disclosure on Form 6.2) AppOinted members of the following boards, councils, commissions,authorities, or other bodies of any county, municipality, school district, independent special district, or other political subdivision: the governing bodyof the subdivision; a community college or junior college district board oftrustees; a board having the power to enforce local code provisions; a boardof adjustment; a planning or zoning board having the power to 'recommend,create, or modify land planning or zoning within the political subdivision,except for citizen advisory committees, technical coordinating committees,and similar groups who only have the power to make recommendations toplanning or zoning boards; a pension board or retirement board empoweredto invest pension or retirement funds or to determine entitlement to or amountof a pension or other retirement benefit.3) Any other appointed member of a local government board ,who isrequired to file a statement of financial interests by the appointing authority orthe enabling legislation, ordinance, or resolution creating the board.

    4) Persons holding any of these pOSitions in local government: Mayor;

    county or city manager; chief administrative employee of a county, municipality, or other political subdivision; county or municipal attorney; chief county ormunicipal building inspector; county or municipal ",{ater resources coordinator; county or municipal pollution control director; county or municipal environmental control director; county or municipal administrator with power togrant or deny a land development permit; chief of police; fife chief; municipalclerk; appointed district school superintendent; community college president;district medical examiner; purchasing agent (regardless of title) having theauthority to make any purchase exceeding $15,000 for the local governmental unit.SPECIFIED STATE EMPLOYEES include the following positionsfor state employees:1) Employees in the office of the Governor or of a Cabinet member whoare exempt from the Career Service System, excluding secretarial, clerical,and similar positions.2) The following positions in each state department, commission,board, or council: Secretary,' Assistant or Deputy Secretary, ExecutiveDirector, Assistant or Deputy Executive DireCtor, and anyone having thepower normally conferred upon such persons, regardless of title.

    3) The following positions in each'state department or division: Director,Assistant or Deputy Director, Bureau Chief, Assistant Bureau Chief, and anyperson having the power normally conferred upon such persons, regardlessof title.4) Assistant State Attorneys, Assistant Public Defenders, PublicCounsel,-full-time state employees serving as counselor assistant counselto a state agency, administrative law judges, and hearing officers.5) The Superintendent or Director of a state mental health institute established for training and research in the mental health field, or any major stateinstitution or facility established for corrections, training, treatment, or rehabilitation.6) State agency Business Managers, Finance and Accounting Directors,Personnel Officers, Grant Coordinators, and purchasing agents (regardlessof title) with power to make a purchase exceeding $15,000.7) The following positions in legislative branch agencies: each employee (other than those employed in maintenance, clerical, secretarial, or similarpositions and legislative assistants exempted by the presiding officer of theirhouse); and. each employee of the Commission on Ethics.

    INSTRUCTIONS FOR COMPLETING FORM!:INTRODUCTORY INFORMATION (At Top of Form):

    If your name, mailing address, public agency, and position arealready printed on the form, you do not need to provide this information unless it should be changed. To change any of this information,write the correct information on the form, then contact y o u r a g e ~ c y ' s financial disclosure coordinator. Your coordinator is identified in thefinancial disclosure portal on the Commission on Ethics'website:www.ethics.state.fl.us.NAME OF AGENCY: This should be the name of the governmental unitwhich you serve or served, by which' you are or were employed, or forwhich you are a candidate. For example, "City of Tallahassee," "LeonCounty," or "Department" of Transportation."OFFICE OR POSITION HELD OR SOUGHT: Use the title of the officeor position you hold, are seeking, or held during the disclosure period (insome cases you may not hold that position now, but you still would berequired to file to disclose your interests during the last year you held thatposition). For example, "City Council Member," "County Administrator,""Purchasing Agent," or "Bureau Chief." If you are a candidate for office orare a new employee or appointee, check the appropriate box.MAILING ADDRESS: If your home address appears on the form butyou prefer another address be shown, change the address as describedabove If you are an active or former officer or employee listed in Section119.071 (4)(d), F.S., whose home address is exempt from disclosure,the Commission is required to maintain the confidentiality of your homeaddress if you submit a written request fo r confidentiality_ Persons

    listed in Section 119.071(4)(d), F.S., are encouraged to provide an addressother than their home address.DISCLOSURE PERIOD: The tax year for most individuals is the calendaryear (January 1 through December 31). If that is the case for you, thenyour financial interests should be reported for the calendar year 2009; justcheck the box and you do not need to add any information in this part ofthe form. However, if you file your IRS tax return based on a tax year that isnot the calendar year, you should specify the dates of your tax year in thisportion of the form and check the appropriate box. This is the time frameor "disclosure period" for your report.MANNER OF CALCULATING REPORTABLE INTERESTS: As noted inthis portion of the form, the Legislature has given filers the option of reporting based on either thresholds that are comparative (usually, based onpercentage values) or thresholds that are based on absolute dollar values.The instructions on the following pages specifically describe the differentthresholds. Simply check the box ,that reflects the choice you have made.You must use the type of threshold you have chosen for each part of theform. In other words, if you choose to report based on absolute dollarvalue thresholds, you cannot use a percentage threshold on any part ofthe form.

    (CONTINUED on page 4) ( ]T'CE FORM 1 - Eft. 1/2010 PAGE 3

  • 8/7/2019 06_01_2010 Financial Disclosure Package

    15/27

    (1) You owned (either directly or indirectly in the form of anPART A - PRIMARY SOURCES OF INCOME equitable or beneficial interest) during the disclosure period more[Required by Sec. 112.3145(3){a)1 or (b)1, Fla. Stat.] than five percent (5%) of the total assets or capital stock of abusiness entity (a corporation, partnership, limited partnership,Part A is intended to require the disclosure of your principal sources of proprietorship, joint venture, trust, firm, etc., doing business inincome during the disclosure period. You do not have to disclose the amount Florida); andof income received. The sources should be listed in descending order,with the largest source first. Please list in this part of the form the name, (2) You received more than ten percent (10%) of your gross incomeaddress, and principal business activity of each source of your income which during the disclosure period from that business entity; and(depending on whether you have chosen to report based on percentage (3) You received more than $1,500 in gross income from thatthresholds or on dollar value thresholds) either: business entity during the period. exceeded five percent (5%) of the gross income received by you in (b) If you are reporting based on dollar value thresholds:your own name or by any other person for your benefit or use during the (1) You owned (either directly or indirectly in the form of andisclosure period, or equitable or benefiCial interest) during the disclosure period moreexceeded $2,500.00 (of gross income received during the disclosure I than five percent (5%) of the total assets or capital stock of aperiod by you in your own name or by any other person for your use or bUSiness entity (a corporation, partnership, limited partnership,benefit). proprietorship, joint venture, trust, firm, etc., doing business inYou need not list your public salary received from serving in the Florida); andposition(s) which requires you to file this form, but this amount should be (2) You received more than $5,000 of your gross income duringincluded when calculating your gross income for the disclosure period. The the disclosure period from that business entity.income of your spouse need not be disclosed. f:lowever, if there is joint If.your interests and gross income exceeded the appropriate thresholds listedincome to you and your spouse from property held by the entireties (such as .above, then for that business entity you must list every source of income tointerest or dividends from a bank account or stocks held by the entireties), the business entity which exceeded ten percent (10%) of the business entity'syou should include all of that income when calculating your gross income and gross income (computed on the basis of the business entity's m ~ s t recentlydisclose the source of that income if it exceeded the threshold. completed fiscal year), the source's address, and the source's principal"Gross income" means the same as it does for income tax purposes, business activity.

    including all income from whatever source derived, such as compensation for Examples:services, gross income from business, gains from property dealings, interest,rents, dividends, pensions, social security, distributive share of partnership - You are the sole proprietor of a dry cleaning business, from whichgross income, and alimony, but not child support. you received more than 10% of your gross income (an amount that wasmore than $1,500) (or, alternatively, more than $5,000, if you are usingExamples: dollar value thresholds). If only one customer, a uniform rental company,- If you were employed by a company that manufactures computers provided more than 1.0% of your dry cleaning business, you must listand received more than 5% of your gross income (salary, commissions, the name of the uniform rental company, its address, and its principaletc.) from the company (or, alternatively, $2,500), then you should list business activity (uniform rentals). the name of the company, its address, and its principal business activity - You are a 20% partner in a partnership that owns a shopping mall(computer manufacturing). and your partnership income exceeded the thresholds listed above. You- If you were a partner in a law firm and your distributive share of should list each tenant of the mall that provided more than 10% of thepartnership gross income exceeded 5% of your gross income (or, partnership's gross income, the tenant's address and principal businessalternatively, $2,500), then you should list the name of the firm, its activity. address, and its principal business activity (practice of law). - You own an orange grove and sell all your oranges to one marketing- If you were the sole proprietor of a retail gift business and your gross cooperative. You should list the cooperative, its address, and its principal income from the business exceeded 5% of your total gross income (or, business activity if your income met the thresholds. alternatively, $2,500), then you should list the name of the business, its address, and its principal business activity (retail gift sales). PART C - REAL PROPERTY- If you received income from investments in stocks and bonds, you [Required by Sec. 112.3145(3){a)3 or (b)3, Fla. Stal.]are required to list only each individual company from which you derivedmore than 5% of your gross income (or, alternatively, $2,500), rather In this part, please list the Io'cation or description of all real property (landthan aggregating all of your investment income. and buildings) in Florida in which you owned directly or indirectly at any timeduring the previous tax year in excess of five percent (5%) of the property's- If more than 5% of your gross income (or, alternatively, $2,500) value. This threshold is the same, whether you are using percentagewas gain from the sale of property (not just the selling price), then thresholds or dollar thresholds. You are not required to list your residencesyou should list as a source of income the name of the purchaser, the and vacation homes; nor are you required to state the value of the propertypurchaser's address, and the purchaser's principal business activity. If on the form. .the purchaser's identity is unknown, such as where securities listed onan exchange are sold through a brokerage firm, the source of income Indirect ownership includes situations where you are a benefiCiary ofshould be listed simply as "sale of (name of. company) stOCk," for a trust that owns the property, as well as situations where you are moreexample. than a 5% partner in a partnership or stockholder in a corporation that ownsthe property. The value of the property may be determined by the most- I f more than 5% of your gross income (or, alternatively, $2,500) recently assessed value for tax purposes, in the absence of a more currentwas in the form of interest from one particular financial institution appraisal. .(aggregating interest from all CO's, accounts, etc., at that institution), . list the name of the institution, its address, and its principal business The location or description of the property should be sufficient to activity. . enable anyone who looks at the form to identify the property. Although alegal description of the property' will dO,sucha lengthy description is notrequired. Using simpler descriptions, such as "duplex, 115 Terrace Avenue,PART B - SECONDARY SOURCES OF INCOME Tallahassee" or 40 acres located at the intersection of Hwy. 60 and 1-95, Lake[Required by Sec. 112.3145(3){a)2 or (b)2, Fla. Stat.] County" is sufficient. In some cases, the property tax identification number ofthe property will help in identifying it: "120 acre ranch on Hwy. 902, HendryThis part is intended to require the disclosure of major customers, County, Tax 10 # 131-45863."clients, and other sources of income to businesses in which you own an (C,ONTINUEO on page 5) (jfFinterest. You will not have anything to report unless:(a) If you are reporting based on percentage thresholds:

    CE FORM 1 - Eft. 112010 PAGE 4

    http:///reader/full/2,500.00http:///reader/full/2,500.00
  • 8/7/2019 06_01_2010 Financial Disclosure Package

    16/27

    Examples: PART E - LIABILITIESYou own 1/3 of a partnership or small corporation that owns both a [Required by Sec. 112.3145(3)(a)4 or (b)4, Fla. Stat.] vacant lot and a 12% interest in an office building. You should disclose the lot, but are not required to disclose the office building (because your In this part of the form, list the name and address of each private or

    1/3 of the 12% interest-which equals 4%-{joes not exceed the 5% governmental creditor to whom you were indebted for a liability in any amountthat, at any time during the disclosure period, exceeded:'threshold).If you are a beneficiary of a trust that owns real p r o p ~ r t y ~ n d your (1) your net worth (if you are using percentage thresholds), ..91interest depends on the duration of an individual's life, the value of your (2) $10,000 (if you are using dollar value thresholds).interest should be determined by applying the appropriate actuarial table You are not required to list the amount o f any indebtedness or your netto the value of the property itself, regardless of the actual yield of the

    worth. You do not have to disclose any of the following: credit card and retailproperty. installment accounts, taxes owed (unless reduced to a judgment), indebtedness on a life insurance policy owed to the company of issuance, contingentPART D - INTANGIBLE PERSONAL PROPERTY liabilities, and accrued income taxes on net unrealized appreciation (an[Required by Sec. 112.3145(3)(a)3 or (b)3, Fla. Stat.] accounting concept). A "contingent liability" is one that will bec.ome an actualliability only when one or more future events occur or fail to occur, such asProvide ageneral description of any intangible personal property t h ~ t , at where you are liable only as a guarantor, surety, or endorser on a promissoryany time during the disclosure period, was worth more than: note. If you are a "co-maker" and have signed as being jointly liable or jointly(1) ten percent (10%) of your total assets (if you are using percentage and severally liable, then this is not a contingent liability; if you are using thethresholds), .91 ' $10,000 threshold and the total amount of the debt (not just the percentageof your liability) exceeds $10,000, such debts should be reported.(2) $10,000 (if you are using dollar value thresholds), Calculations for persons using comparative (percentage) thresholds: Inand state the business entity to which the property related. Intangible per order to decide whether the debt exceeds your net worth, you will need tosonal property includes such things as money, stocks, bonds, certificates of total all of your liabilities (including promissory notes, mortgages, credit carddeposit, interests in partnerships, beneficial interests in a trust, promissory debts, lines of credit, judgments against you, etc.). Subtracl this amount fromnotes owed to you, accounts receivable by you, IRA's, and bank accounts. the value of all your assets as calculated above for Part D. This is your "netSuch things as automobiles, houses, jewelry, and paintings are not intan worth." You must list on the form each creditor to whom your debt exceededgible property. Intangibles relating to the same business entity should be this amount unless it is one of the types of indebtedness listed in the paraaggregated; for example, two certificates of deposit and a savings account graph above (credit card and retail installment accounts, etc.). Joint liabilitieswith the same bank. Where property is owned by husband and wife as ten with others for which you are "jointly and severally liable: meaning that youants by the entirety (which usually will be the case), the property should be may be liable for either your part or the whole of the obligation, should bevalued at 100%. included in your calculations based upon your percentage of liability, withCalculations: In order to decide whether the intangible property exceeds the following exception: joint and several liability with your spouse for a debt10% of your total assets, you will need to total the value of all o f your assets which relates to property owned by both of you as "tenants by the entirety"(including real property, intangible property, and tangible personal property (usually the case) should be included in your calculations by valuing the assetsuch as automobiles, jewelry, furniture, etc.). When making this calculation, at 100% of its value and the liability at 100% of the amount owed.

    do not subtract any liabilities (debts) that may relate to the property-add Examples for persons using comparative (percentage) thresholds:only the fair market value of the property. Multiply the total figure by 10% toarrive at the disclosure threstlOld. List only the intangibles that exceed this - You owe $15,000 to a bank for student loans, $5,000 for creditthreshold amount. Jointly owned property should be valued according to the card debts, and $60,000 (with your spouse) to a savings and loan for apercentage of your joint ownership, with the exception of property owned by home mortgage. Your home (owned by you and your spouse) is worth,husband and wife as tenants by the entirety, which should be valued at 100%. $80,000 and your other property is worth $20,000. Since your net worthNone of your calculations or the value of the property have to be disclosed on is $20,000 ($100,000 minus $80,000), you must report only the namethe form. If you are using dollar value thresholds, you do not need to make and address of the savings 'and loan.any of these calculations. - You and your 50% business partner have a $100:000 business loanExamples for persons using comparative (percentage) thresholds: from a bank, for which you both are jointly and severally liable. Thevalue of the business, taking into account the loan as a liability of the- You own 50% of the stock of a small corporation that is worth business, is S50,000. Your other assets are worth $25,000, and you$100,000, according to generally accepted methods of valuing small owe $5,000 on a credit card. Your total assets will be $50,000 (half ofbusinesses. The estimated fair market value of your home and other a business worth $50,000 plus $25,000 of other assets). Your liabilities,property (bank accounts, automObile, furniture, etc.) is $200,000. As for purposes of calculating your net worth, will be only $5,000, becauseyour total assets are worth $250,000, you must disclose intangibles the full amount of the business loan already was included in valuing theworth over $25,000. Since the value of the stock exceeds this threshold, business. Therefore, your net worth is $45,000. Since your 50% shareyou should list "stock" and the name of the corporation. If your accounts 6f the $100,000 business loan exceeds this net worth figure, you mustwith a particular bank exceed $25,000, you should list "bank accounts" list the bank.and bank's name.- When you retired, your professional firm bought out your partner PART F INTERESTS IN SPECIFIEDship interest by giving you a promissory note, the present value of which is $100,000. You also have a certificate of deposit from a bank BUSINESSES worth $75,000 and an investment portfOlio worth $300,000, conSisting [Required by Sec. 112.3145(5), Fla. Stat.]of $100,000 of IBM bonds and a variety of other investments worthbetween $5,000 and $50,000 each. The fair market value of your The types of businesses covered in this disclosure are only: state andremaining assets (condominium, automobile, and other personal prop federally chartered banks; state and federal savings and loan associations;erty) is $225,000. Since your total assets are worth $700,000, you must cemetery companies; insurance companies (including insurance agencies);list each intangible worth more than $70,000. Therefore, you would list mortgage companies; credit unions; small loan companies; alcoholic bever"promissory note" and the name of your former partnership, certificate age licensees; pari-mutuel wagering companies, utility companies, entitiesof deposit" and the name of the bank, "bonds" and "IBM," but none of controlled by the Public Service Commission; and entities granted a franchisethe rest of your investments. to operate by either a city or a county government.

    (CONTINUED on page 6) q rCE FORM 1 Eft. 1/2010 PAGE 5

  • 8/7/2019 06_01_2010 Financial Disclosure Package

    17/27

    You are required to disclose in this part of the form the fact that youowned during the disclosure period an interest in, or held any of certain positions with, particular types of businesses listed above. You are required tomake this disclosure if you own or owned (either directly or indirectly in theform of an equitable or beneficial interest) ai any time during the disclosureperiod more than five percent (5%) of the total assets or capital stock of oneof the types of business entities granted a privilege to operate in Florida thatare listed above. You also must complete this part of the form for each ofthese types of businesses for which you are, or were at any time during the

    disclosure period, an officer,director, partner, proprietor, or agent (other thana resident agent solely for service of process).If you have or held such a position or ownership interest in one of thesetypes of businesses, list (vertically for each business): the name of the business, its address and principal business activity, and the position held withthe business (if any). Also, if you own(ed) more than a 5% interest in thebusiness, as described above, you must indicate that fact and describe thenature of your interest.

    (End of Instructions.)

    PENALTIESA failure to make any required disclosure constitutes grounds for and may be punished by one or more of the following: dis qualification from being on the ballot, impeachment, removal or suspension from office or employment, demotion, reduction insalary, reprimand, or a civil penalty not exceeding $10,000. [Sec. 112.317, Florida Statutes]Also, if the annual form is no t filed by September 1st, a fine of $25 fo r each day late will be imposed, up to a maximumpenalty of $1,500. [Section 112.3145, F.S. J.

    OTHER FORMS YOU MAY NEED TO FILEIN ORDER TO COMPLY WITH THE ETHICS LAWS

    In addition to filing Form 1, you may be required to file one or more of the special purp'ose forms listed below, depending on your particular position,business activities, or interests. As it is your duty to obtain and file any of the special purpose forms which may be applicable to you, you should carefullyread the brief description of each form to determine whether it applies. .Form 1 F - Final Statement of FinancialInterests: Required of local officers, state officers, and speci

    fied state employees within 60 days after leaving office or employment.This form is used to report financial interests between January 1st of thelast year of office or employment and the last day of office or employment. [Sec. 112.3145(2)(b). Fla. Stat.]Form 1X - Amended Statement of FinancialInterests: To be used by local officers, state officers, and speci fied state employees to correct mistakes on previously filed Form 1's.[Sec. 112.3145(9). Fla. Stat.]Form 2 - Quarterly Client Disclosure: Requiredof local officers, state officers, and specified state employees todisclose the names of clients represented for compensation by themselves or a partner or associate before agencies at the same level ofgovernment as they serve. The form should be filed by the end of thecalendar quarter (March 31, June 3D, Sept. 3D, Dec. 31) following thecalendar quarter in which a reportable representation was made'. [Sec.112.3145(4). Fla. Stat.]Form. 3A Stat.ement.of Interest in CompetitiveBid for Public Busmess: Required of public officers andpublic employees prior to or at the time of submission of a bid for publicbusiness which otherwise would violate Sec. 112.313(3) or 112.313(7),Fla. Stat. [Sec. 112.313(12)(b), Fla. Stat.]Form 4A Disclosure ofBusiness Transaction,Relationship, or Interest: Required of public officers andemployees to disclose certain business transactions, relationships, orinterests which otherwise would violate Sec. 112.313(3) or 112.313(7),Fla. Stat. [Sec. 112.313(12) and (12)(e), Fla. Stat.]Form 8A Memorandum of Voting Conflict fo rState Officers: Required to be filed by a state ofticerwithin 15days after having voted on a measure which inured to his or her special

    private gain (or loss) or to the special gain (or loss) of a relative, business associate, or one by whom he or she is retained or employed. Eachappointed state officer who seeks to influence the decision on such ameasure prior to the meeting must file the form before undertaking thataction. [Sec. 112.3143, Fla. Stat.]Form 88 Memorandum of Voting Conflict forCo,!nty, Municipal, and Other 'Local PublicOfficers: ,Required to be filed (within 15 days of abstention) byeach local officer who must abstain from voting on a measure whichwould inure to his or her special private gain (or loss) or the special gain(or loss) of a relative, business associate, or one by whom he or she isretained or employed. Each appOinted local official who seeks to influence the decision on such a measure prior to the meeting must file theform before undertaking that action. [Sec. 112.3143, Fla. Stat.]Form 9 - Quarterly Gift Disclosure: Required oflocal officers, state officers, specified state employees, and state.procurement employees to report gifts over $100 in value. The formshould be filed by the end of the calendar quarter (March 31, June 30,September 3D, or December 31) following the calendar quarter in whichthe gift was received. [Sec. 112.3148, Fla. Stat.]Form 10 - Annual Disclosure of Gifts fromGovernmental Entities and Direct Sup'portOrganizations and Honorarium Event RelatedExpenses: Required of local officers, state officers, specifiedstate employees, and state procurement employees to report giftsover $100 in value received from certain agencies and direct supportorganizations; also to be utilized by these persons to report honorariumevent-related expenses paid by certain persons and entities.The formshould tie filed by July 1 following the calendar year in which the gift orhonorarium event-related expense was received. [Sec. 112.3148 and

    112.3149, Fla. Stat.]

    AVAILABILITY OF FORMS; FOR MORE INFORMATIONCopieS of these forms are available from the Supervisor of Electionsin your county; from the Commission on Ethics, Post Office Drawer15709, Tallahassee, Florida 32317-5709; telephone (850) 488-7864;and at the Commission's web site: www.ethics.state.f1.us.

    Questions about any of these forms or the ethics laws may beaddressed to the Commission on Ethics, Post Office Drawer 15709,Tallahassee, Florida 32317-5709; telephone (850) 488-7864.

    CE FORM 1 - Eft. 1/2010 PAGE 6

  • 8/7/2019 06_01_2010 Financial Disclosure Package

    18/27

    APPENDIX B

    ~ M = I = M = I ' D ~ ~ - ____ ~ S ~ O ~ U ~ R ~ C = E ~ O ~ F ~ I N ~ C ~ O ~ M ~ E ~ S ~ T A ~ T ~ E = M ~ E = N ~ T ~ ________ ~ l Disclosure for tax year ending:First Name Middle Name/Initial Last Name

    BARCODE

    '.Mailing Address street number, street name, or P.O. Box

    City, State, Zip Employee ID #:..I f your home address IS your mailing address, and your home address IS exempt from pubhc records pursuant to Fla. Stat.

    119.07, read instructions on the following page and check here 0:Filing as a: o County Employee

    o Municipal Employee of___________________ _Position held or sought: _-:--_______________________ _Board where serving:______________ Term or employmentbeganon:____________Dept. where Workemployed:_____________ telephone:,_________'Work address:

    Please list below in descending order, with the largest source first, the name, address, and principalbusiness activity of every source of your income, including public salary you received or used duringthe disclosure period or any person who received for your benefit. The income of your spouse or anybusiness partner need not be disclosed. I f continued on a separate sheet, check here: 0Description of the PrincipalName of Source fJf Income Address Business Activity

    I hereby swear (o r affirm) that the aforesaid information is a true and correct statement.

    Signature of person disclosing Print name Date signedCOE,2008

  • 8/7/2019 06_01_2010 Financial Disclosure Package

    19/27

    ~ o u r c e of Income InformationRequired by the Miami-Dade County Code, Section 2-11.1(i)

    The term INCOME shall include, but is not limited to, the following items: wages, salaries; tips; bonuses;commissions & fees; dividends, interest; profits from businesses anc! professions; your share of profits frompartnerships and small business corporations; pensions, annuities & endowments; profits from the sale orexchange of real estate, securities or other property, including personal residence; rents and royalties; your shareor estate or trust income, including accumulated distributions; alimony, separate maintenance or supportpayments; prizes, awards and gifts; fees as an Executor, Administrator or Director; disability retirementpayments; workmen's compensation, insurance; damages; etc.Filing Instructions

    A "Source of Income Form," "Financial Statement,n "Form 1,n or a copy of the personal income ta xforms ma y be filed to satisfy the filing requirement fo r County employees, municipal employees,and advisory board members.

    This form must be filed by July 1st of each year. This form should no t be used as a substitute fo r Form 1 fo r those required to file under state requirements.

    Miami-Dade County Personnel and Advisory Board members shall file completed forms with:. Miami-Dade Elections Department2700' NW 8 ~ h Avenue

    Miami, FL 33172 Or P.O. Box 521550

    Miami, FL 33152-1550 Municipal Personnel and Advisory Board Members shall file completed forms with:. Their respective Municipal Clerk.

    For further information contact theMiami-Dade Elections Department at 305-499-8413 or your Municipal Clerk's Office

    Note re: Florida Statutes 119.07: The role of our office is to receive and maintain forms filed aspublic records. If your home address is exempt from disclosure and you do not wish your homeaddress to be made public, please use your office or other address for your mailing address. Thefollowing persons are exempt from disclosing .their home addresses: active or former law enforcementpersonnel, including correctional and correctional probation officers, personnel of the Department ofChildren and Family Services whose duties include the investigation of abuse, neglect, exploitation,fraud, theft, or other criminal activities, personnel of the Department of Health whose duties are tosupport the investigation of child abuse or neglect, and personnel of the Department of Revenue orlocal governments whose responsibilities include revenue collection and enforcement or child supportenforcement; firefighters; justices and judges; current or former state attorneys, assistant stateattorneys, statewide prosecutors, or assistant statewide prosecutors; county and municipal code. inspectors and code enforcement officers. .

    COE,2008

  • 8/7/2019 06_01_2010 Financial Disclosure Package

    20/27

    APPENDIX C

    Form 9 QUARTERLY GIFT DISCLOSURE(GIFTS OVER $100)LAST NAME FIRST NAME MIDDLE NAME: NAME OF AGENCY:

    MAILING ADDRESS: IOFFICE OR POSITION HELD:CITY: ZIP: COUNTY: FOR QUARTER ENDING (CHECK ONE): YEAR

    OMARCH OJUNE CJSEPTEMBER CJ DECEMBER 2 0 _

    PART A - STATEMENT OF GIFTSPlease list below each gift, the value of which you believe to exceed $100, accepted by you during the calendar quarter for which this statement !3being filed. You are required to describe the gift and state the monetary value of the gift, the name and address of the person making the gift, and thedate(s) the gift was received. If any of these facts, other than the gift description, are unknown or not applicable, you should so state on the form. Asexplained more fully in the instructions on the reverse side of the form, you are not required to disclose gifts from relatives or certain other gifts. Youare no t required to file this statement fo r any calendar quarter during which you did not receive a reportable gift.

    DATERECEIVED DESCRIPTIONOF GIFT MONETARYVALUE NAME OF PERSONMAKING THE GIFT ADDRESS OF PERSON. MAKING THE GIFT\

    CJ CHECK HERE IF CONTINUED ON SEPARATE SHEET

    PART B - RECEIPT PROVIDED BY PERSON MAKING THE GIFTIf any receipt for a gift listed above was provided to you by the person making the gift, you are required to attach a copy of that receipt to thisform. 'fou may attach an explanation of any differences between the information disclosed on this form and th e information on the receipt.o CHECK HERE IF A RECEIPT IS ATTACHED TO THIS FORM

    PARTC-OATHI, the person whose name appears at the beginning o f this form, dodepose on oath or affirmation amI say that the information disclosedherein and on any attachments made by me constitutes a true accurate,and total listing of all gifts required to be reported by Section 112.3148,Florida Statutes.

    SIGNATURE OF REPORTING OFFICIAL

    STATE OF FLORIDACOUNTY OFSworn to (or affirmed) and subscribed before me thisday of ,2 0by

    (Signature of Notary PUblic-State of Florida)

    (Print, Type, or Stamp Commissioned Name of Notary Public)Personally Known OR Produced IdentificationType of Identification Produced

    PART D - FILING INSTRUCTIONSThis form, when duly signed and notarized, must be filed with the Commission on Ethics, P.O. Drawer 15709, Tallahassee, Florida 32317-5709; physical address: 3600 Maclay Blvd. South, Suite 201, Tallahassee, Florida 32312. The form must be filed no later than the last day of the calendar quarterthat follows the calendar quarter for which this form is filed (For example, if a gift is received in March, i t should be disclosed by June 30.)

    CE FORM 9 - EFE 1/2007 (See reverse side for instructions) r::tr

  • 8/7/2019 06_01_2010 Financial Disclosure Package

    21/27

    PART E - INSTRUCTIONS WHO MUST FILE THIS FORM? to a professional license or certificate; other personal services forwhich a fee is normally charged by the person providing the serVices;Any individual, including a candidate upon qualifying, who is required and any other similar service or thing hailing an attributable valueby law to file full and public disclosure of his financial interests on and not already described.Commission on Ethics Form 6, except Judges. (See Form 6 for a list ofpersons required to file that form.) The following are NOT reportable as gifts on this form: salary. benefits,services, fees, commissions, gifts, or expenses associated primarilyAny individual, including a candidate upon qualifying, who is required with your ernployment, business, or service as an officer or director ofby law to file a statement of financial interests on Commission on Ethics a corporation or organization; contributions or expenditures reportedForm 1. (See Form 1 for a list of persons required to file that form.) pursuant to the election laws, campaign-related personal servicesAny procurement employee of the executive branch or judicial branch of provided without compensation by individuals volunteering their time, orstate govemment. This inc ludes any employee who participates through any other contribution or expenditure by a political party; an honorariumdecision, approval, disapproval, recommendation, preparation of any or an expense related to an honorarium event paid to you or yourpart of a purchase request, influencing the content of any specification . spouse; an award. plaque, certificate, or similar personalized item given

    or procurement standard, rendering of advice, investigation, or auditing in recognition of your public, civic, charitable, or professional service; anor in any other advisory capacity in the procurement of contractual honorary membership in a service or fraternal organization presentedservices or commodities as defined in Section 287.012, Florida Statutes, merely as a courtesy by such organization; the use of a governmentalif the cost of such services or commodities exceeds $1 ,000 in any year. agency's public facility or public property for a public purpose. Alsoexempted are some gifts from state, regional, and national organizationsNOTE: Gifts that formerly were allowed under Section 112.3148, F.S., that promote the exchange of ideas between, or the professivnalnow may be prohibited expenditures under Sections 11.045 and development of, govemmental officials or employees.112.3215, F.S. HOW DO I DETERMINE THE VALUE OF AWHAT GIFTS ARE REPORTABLE? Any gift (as defined below) you received which you believe to be in GIFT?excess of $1 00 in value, EXCEPT: The value of a gift provided to you is determined using the actual cost to

    1) Gifts from the following RELATIVES: father, mother. son, daughter, the donor, and, with respect to personal services provided by the donor,brother, sister, uncle, aunt, first cousin, nephew, niece, husband, wife, the reasonable and customary charge regularly charged for such servicefather-in-law, mother-in-law, son-in-law, daughter-in-law, brother-in in the community in which the service is provided. Taxes and gratUitieslay/, sister-In-law, stepfather, stepmother, stepson, stepdaughter, are not included in valuing a gift. If additional expenses are required asstepbrother, stepsister, half brother, half sister, grandparent, great a condition precedent to the donor's eligibility to purchase or provide agrandparent,' grandchild, great grandchild, step grandparent, step gift and the expenses are primarily for the benefit of the donor or are of agreat grandparent, step grandchild, step great grandchild, a person charitable nature, the expenses are not included in determining the valuewho is engaged to be married to you or Who otherwise holds himself of the gift.or herself out as or Is generally known as the person whom you intend Compensation provided by you to the donor within 90 days of receivingto marry or with whom you intend to form a household, or any other the gift shall be deducted from the value of the gift in determining thenatural person having the same legal residence as you. value of the gift.

    2) Gifts which you are prohibited from accepting by Sections 112.313(4) If the actual gift value attributable to individual participants at an eventand 112.3148(4), Florida Statutes. These include any gift which you cannot be determined, the total costs should be prorated among allknow or, with the exercise of reasonable care, should know was invited persons. A gift given to several persons may be attributed amonggiven to influence a vote or other action in which you are expected all of them on a pro rata basis. Food, beverages, entertainment, etc.,to participate in your official capacity; it also includes a gift worth over provided at a function for more than ten people should be valued by$100 from a political committee or committee of continuous existence dividing the total costs by the number of persons invited, unless the itemsunder the elections law, from a lobbyist who lobbies your agency or are purchased on a per-person basis, in which case the per-person costwho lobbied your agency within the past 12 months, or from a partner, should be used. firm, employer, or principal of such a lobbyist. Transportation should be valued on a round-trip basis unless only one3) Gifts worth over $100 for which there is a public purpose, given to way transportation is provided. Round-trip transportation expensesyou by an entity of the legislative or judicial branch, a department or should be considered a single gift. Transportation provided in a privatecommission of the executive branch, a water management district conveyance should be given the same value as transportation providedcreated pursuant to s. 373.069, South Florida Regional Transportation in a comparable commercial conveyance. Authority, the Technological Research and Development Authority, Lodging provided on consecutive days should be considered a singlea county, a municipality, an airport authority, or a school board; or gift. Lodging in a plivate residence should be valued at $44 per night. .a gift worth over $100 given to you by a direct-support organizationspecifically authorized by law to support the govemmental agency of Food and beverages consumed at a single Sitting or event are a singlewhich you are an officer or employee. These gifts must be disclosed gift valued for that sitting or meal. Other food and beverages providedon Form 10. on a calendar day are considered a single gift, with the total valu

  • 8/7/2019 06_01_2010 Financial Disclosure Package

    22/27

    APPENDIX D

    FORM 10ANNUAL DISCLOSURE OF GIFTS FROM GOVERNMENTALENTITIES AND DIRECT SUPPORT ORGANIZATIONS ANDHONORARIUM EVENT RELATED EXPENSES

    LAST NAME FIRST NAME MIDDLE NAME: THIS STATEMENT REFLECTS GIFTS AND HONORARIUM EVENTRELATED EXPENSES RECEIVED DURING CALENDAR YEAR200_"_00 NOT FILE nilS FORM IF YOU HAVE NOTHING TO REPORT ON IT.

    MAILING ADDRESS: NAME OF AGENCY:

    CITY: ZIP: COUNTY: OFFICE OR POSITION HELD:

    NOTICE: Under provisions of Sec. 112.317, Fla. Stat., a failure to make any required disclosureconstitutes grounds for and may be punished by one or more of the following: impeachment, removal orsuspension from office or employment, demotion, reduction in salary, reprimand or a fine up to $10,000.

    PART A -- GIFTS (HAVING A PUBLIC PURPOSE) FROM GOVERNMENTAL ENTITIESNAME OF PERSONPROVIDING GIFT(S) TOTAL VALUE OF GIFTSFROM THAT PERSON DESCRIPTION OFINDIVIDUAL GIFTS DATE EACHGIFT RECEIVED

    PART B GIFTS FROM DIRECT SUPPORT ORGANIZATIONSNAME OF PERSONPROVIDING GIFT(S)

    TOTAL VALUE OF GIFTSFROM THAT PERSON

    DESCRIPTION OFINDIVIDUAL GIFTS

    DATE EACHGIFT RECEIVED

    PARTC _. HONORARIUM EVENT RELATED EXPENSES" EVENT#1 EVENT #2

    NAME OF PERSONPAYING EXPENSES INSTRUCTIONS~ A ~ D - D - R - E - S - S - O - F - ~ ~ - - ~ - - - - - - - - - ~ - - - - - - - - - ~ o n w h o m u ~ f i ~ f u ~ f u r m ...P_E_R_S_O_N_______+-________--'--+-__ -'--______ - I an d how to fill it out are

    AFFILIATION on the reverse side.OF PERSONAMOUNT OF FILING

    ~ H - O - N - O - R - A - R - I U - M - - E X - P - E - N - S - E S - - _ r - - - - - - - - - - - - - - - - ~ r _ - - - - - - - - - - - - - - ~ I N S T R U C T I O N S DATE(S) OF fo r when an d where to file...T_H_E_EV_E_N_T______+-_________-+-_________ - I this form are located onDESCRIPTION OF the reverse side.EXPENSES PAID"EACH DAYTOTAL VALUE OFEXPENSES FOR THE EVENTCEFORM10-EFF1n007 (Continued on reverse side) PAGE 1

  • 8/7/2019 06_01_2010 Financial Disclosure Package

    23/27

    IF ANY OF PARTS A THROUGH C ARE CONTINUED ON A SEPARATE SHEET PLEASE CHECK HERE 0REMEMBER TO ATTACH COPIES OF ALL STATEMENTS. PROVIDED TO YOU BY PERSONS AND ENTITIES PROVIDING OR PAY ING FOR THE GIFTS AND HONORARIUM EVENT RELATED EXPENSES DISCLOSED ON THIS FORM. YOU MUST DISCLOSEALL OF THESE KINDS OF GIFTS AND EXPENSES EVEN THOUGH YOU DID'NOT RECEIVE A STATEMENT OR REPORT FROMTHE PERSON OR ENTITY PROVIDING THEM. YOU MAY EXPLAIN ANY DIFFERENCES BETWEEN THE ATTACHED REPORTSAND STATEMENTS AND THE INFORMATION PROVIDED ON THIS FORM BY ATTACHING AN EXPLANATION TO THE FORM.SIGNATURE: DATE SIGNED:

    INSTRUCTIONS FORCOMPL"ETING AND FILINGFORM 10:WHEN AND WHERE TO FILE: By,Iuly 1 of the year following the year coveredby this form. Persons who file Form 1 orForm 6 should file this form with their Form1 or Form-6. State procurement employees(see definition below) file this form with theCommission on Ethics, P.O. Drawer. 15709,Tallahassee, Florida 32317-5709; physicaladdress:' 3600 Maclay Blvd. South, Suite101, Tallahassee, FL 32312. This formneed not be filed unless a reportable gift orexpense was received during the time YOUheld public office or employment. 'WHO MUST FILE FORM 10: Allpersons who are required to file Form1, Statement of Financial Interests, andall persons who file Form 6, Full andPublic Disclosure of Financial Interests,including candidates (comprehensive listsare part of each of those forms) exceptjudges. In addition, state "procurementemployees" are required to file Form 10,as we!! as former reporting individualsand procurement employees wholeft office or employment during thecalendar year covered by the report. Youare a "procurement employee" if you:

    (1) Are.an employee of an office,department, board, commission, orcouncil of the executive or judicialbranches of state government; and(2) Participate in the procurement

    of contractual services or commoditiescosting more than $1,000 in any year,through decision, approval, disappr.oval,recommendation, preparation of any partof a 'purchase request, in fluencing thecontent of any specification or procurementstandard, rendering of advice, investigation,auditing, or any other advisory capacity.INTRODUCTORY INFORMATION(At the top o f the form):

    CALENDAR YEAR: Write the yearcovered by this form.NAME OF AGENCY: This should bethe name of the governmental unit whichyou serve or served, sought election to,or by which you are or were employed.For example, "City of Tallahassee,""Florida Senate," or "Department ofTransportation:OFFICE OR POSITION HELD: Usethe title of the office or position you hold,sought, or held during the year covered

    by this form (in some cases you maynot hold that position now, but you stillwould be required to file to disclose yourinterests during the last year you heldthat position) For example, "City CouncilMember," "Member," "PurchaSingAgent," or "Bureau Chief."MAILING ADDRESS: Write yourcurrent mailing address here. If you arean active or former officer or employeelisted in Section 119.071 (4)(d),F.S.,.whose home address is exempt fromdisclosure, the Commission is requiredto maintain the confidentiality of yourhome address if you submit a writ/en

    request for confidentiality. Persons listedin Section 119.071 (4)(d),F.S. shouldprovide an address other than theirhome address, if possible.PART A""; GIFTS FROMGOVERNMENTAL ENTITIES[Required by Sec. 112.3148, Fla. Stat.]Entities of the legislative or judicialbranches, departments and commissions ofthe executive. branch, counties, muniCipalities,airport authorities, school boards, watermanagement districts created by 373.069,F:S., the Technological Research andDevelopment Authority, and the South FloridaRegional Transportation Authority may give,. either directly or indirectly, a gift worth over$100 to persons who file Fonm 1 or Fonm 6or to state procurement employees iLa publicpurpose can be shown for the gift. Part Ashould be used to list 'such gifts. Under thelaw, these governmental entities are' requiredto provide you with a statement concerningthese gifts by March 1; attach this statementto Fonm 10.PART 8 - GIFTS FROM DIRECTSUPPORT ORGANIZATIONS[Sec. 112:3148, Fla. Stat.)

    Direct support organizations specificallyauthorized by law to support a governmentalentity may give a gift worth over $100 to aperson who files Form 1 or Fonm 6 or to astate procurement employee i f the personor employee is an officer or employee of thatgovernmental entity. Part B should be usedto list such gifts. Under the law, these directsupport organizations are required to provideyou with a statement concerning these giftsby March 1; attach this statementto Form 10.

    "

    PART C HONORARIUM EVENTRELATED EXPENSES[Required by Sec. 112.3149; Fhi. Stat.]Reporting individuals who file Form 1and Fonm 6 and state procurement employeesare prohibited from accepting an honorarium(a payment in exchange for a speech, oralpresentation, writing, and the like) from apolitical committee or committee of continuousexistence, from a lobbyist who lobbies them ortheir public agency (or has done so within theprevious 12 months), and from the employer,principal, partner, or finm of such a lobbyist.However, these persons and entities maypayor provide a reporting individual orprocurernent employee and his or her spouse

    for actual and reasonable transportation,lodging, event or meeting registration fee,and food and beverage expenses related toan event at which a speech, presentation, orwriting will be made by the public officer oremployee. Part C should be used to describethese honorarium event related expenses.Under the law, the persons or entities payingfor or providing such expenses are required toprovide you with a statement concerning themwithin 60 days ofthe honorarium event; attachthis statement to Fonm 10.

    Gifts that formerly were allowed underSections 112.3148 and 112.3149, F.S.,now may be prohibited expenditures underSections 11.045 and 112.3215, F.S.FOR MORE INFORMATIONQuestions about this form or the ethicslaws may be addressed to the Commissio'non Ethics, Post Office Drawer 15709,Tallahassee, Florida 32317-5709; telephone(850) 488-7864; information is also 'providedat: www.ethics.state.fl.us.

    CEFORM10-EFF1nom PAGE 2

  • 8/7/2019 06_01_2010 Financial Disclosure Package

    24/27

    APPENDIX E

    "'DADE. OUTSIDE EMPLOYMENT STATEMENTFor Full-time County and Municipal EmployeesFull-time County and municipal employees engaging in outsideemployment must file an annual disclosure report by July 1st of Disclosure foreach year, in accordance with Section 2-11.1(k)(2) of the Miami- Tax Year Ending:Dade County Code.Last Name:

    First Name: Middle Name:

    Employee ID #:

    Filing as (check one) D Miami-Dade Co. EmployeeD Municipal Employee of:Position Title:

    I

    County/Municipal Department County/Municipal Division:' "

    If your home address is exempt from public recordspursuant to Florida .Statutes 119.07, please see the Dnote on the following page and check here:Work Telephone:

    Mailing Address (Street Name andNumber) Apt. #

    City State Zip Code

    Please list the sources of outside employment, the nature of the work, and the amounts of money or othercompensation you received. If continued on a separate sheet; please check here: D

    Name and Address of the Source ofOutside Income Nature of the WorkPerformed Amount of Money orCompensation Received

    I hereby swear (or affirm) that the aforesaid information is a true and correct statement.Signature of Person Disclosing Date Signed

    COE.2008

  • 8/7/2019 06_01_2010 Financial Disclosure Package

    25/27

    Outside Employment Statement Page 2OUTSIDE EMPLOYMENT INFORMATIONRequired by the Miami-Dade County Code, Section 2-11.1 (k)(2)

    OUTSIDE EMPLOYMENT means the providing of services, other than to Miami-DadeCounty, or to the respective municipality, for compensation, including but not limited to,being an employee, an independent contractor, an' agent, or by self-employment.FILING INSTRUCTIONS

    This form must be, filed by July 1st of each year. The form should only be filed byemployees who have outside employment to disclose.Miami-Dade County personnel shall file completed forms with:

    Miami-Dade Elections Department 2700 NW aih Ave. Miami, FL 33172

    orP.O; Box 521550 Miami, FL 33152-1550

    Municipal personnel shall file completed forms with: 'Their Respective Municipal Clerk

    For further information, contact the Miami-Dade Elections Department at (305) 499-8413 oryour respective Municipal Clerk's Office.

    Note re: Florida Statutes 119.07: The role of our office is to receive and maintain forms filed as public records. If your home address is exempt from disclosure 'and you do not wish your home address to be made public, please use your office or other address for your mailing address. The following persons are exempt from disclosing their home addresses: active or former law enforcement personnel, including correctional and correctional . probation officers, personnel of the Department of Children and Family Services whose duties include the investigation of abuse, neglect, exploitation, fraud, theft, or other criminal activities, personnel of the Department of Health whose duties ~ r e to support the . investigation of child abuse or neglect, and personnel of the Department of Revenue orlocal governments whose responsibilities include revenue collection and enforcement .orchild support enforcement; firefighters; justices and judges; current or former stateattorneys, assistant state attorneys, statewide prosecutors, or assistant statewideprosecutors; county and municipal code inspectors and code enforcement officers.

    COE,2008

  • 8/7/2019 06_01_2010 Financial Disclosure Package

    26/27

    POLICY NUMBER:APM- 2 - 08

    CITY OF MIAMI

    ADMINISTRATIVE POLICY

    DATE:l!lne 26, 2008

    REVISIONSREVISED DATE OFSECTION REVISIONCreated 1/28108Revised 0612008

    Page 1 of2SUBJECT: SOCIAL SECURITY NUMBERS PURPOSE: To establish a policy regarding the collection and dissemination of Social

    Security numbers in accordance with Section 119.071(5), Florida Statutes(2007).THE POLICY WILL BE AS FOLLOWS:I APPLICABILITY - INDIVIDUALS

    The City of Miami ("City") obtains the Social Security numbers of individuals,including but no t limited to: applicants, employees, volunteers, board members,temporary-agency personnel, consultants, vendors, arbitrators, and hearing officers,for the purposes stated below in Section II. .

    II PURPOSE OF COLLECTIONIDISSEMINATIONThe City collects and/or disseminates Social Security numbers for one or more ofthefollowing purposes:A. Identification and VerificationB. Validating Educational CredentialsC. Background Checks/ScreeningD. Data CollectionE. Tax ReportingF. Benefit(s) ProcessingG. Retiring or Pension Board(s) ReportingH. . Workers' Compensation ClaimsI. Group, Life and/or Dental CoverageJ. Source of Income StatementiFormK. Direct DepositL. Positive PayM. Garnishment

  • 8/7/2019 06_01_2010 Financial Disclosure Package

    27/27

    N. Credit WorthinessO. Billing and Payments/Collection AgencyP. TrackingQ. Classification of AccountsR. Numeric Identifier and use for search purposesS. Any other reason that is determined imperative for the performallce of theCity's duties and responsibilities as prescribed by law or any other reasonspecifically authorized by l a ~ .