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HomeMy WebLinkAboutAIPPB Memo and Applications4_..•, 40 CITY OF MIAMI, FLORIDA INTER -OFFICE MEMORANDUM TO: James Reyes, City Manager FROM: Sevanne Steiner Assistant Director, Planning Department DATE: June 9, 2026 SUBJECT: Appointment to the Art in Public Places "AIPP" Board REFERENCES: Chapter 62, Article XVI, Section 62- 655 During the period prior to the April 7, 2026 deadline, the City Clerk published in various newspapers a Notice of Vacancies requesting volunteers to serve on the Art in Public Places Board. The Art in Public Places Board (AIPPB) is composed of nine (9) voting members and two (2) alternate members appointed by the Mayor and City Commission. It is intended that members and alternate members of the AIPPB be persons of knowledge, experience, mature judgment, and background; having ability and desire to act in the public interest; and representing the various special professional training, experience, and interests required to make informed and equitable decisions concerning the artistic development of the city. The Planning Department has reviewed applications in accordance with Section 62-655 of the Miami City Code, as well as the adopted Art in Public Places Master Plan and AIPPB Rules of Procedure. As such, staff recommends the following appointment: • Appoint Lissette Garcia Arrogante as the District 3 Art in Public Places Board Member with a waiver of employment. • Lissette Garcia Arrogante holds a Bachelor of Arts in Art History from Florida International University and a Master of Public Administration from Baruch College. She currently serves as Director of the Tourism and Culture Department for the City of Miami Beach and has extensive experience in public art, cultural affairs, and arts administration. • As per City Code Section 2-884(e). (e) Except as specifically provided in the Charter or the Code, an employee of Miami -Dade County, Florida, or any municipality therein other than a city employee, shall not serve on or be appointed to any board of the city, unless the city commission waives this restriction by a four -fifths affirmative vote of its membership and the employee is a resident of the city. • Appoint Jennifer Bunsa as an At Large in Public Places Board Member to replace Odalys De Yurre who's term has expired and has indicated her wish to resign. • Jennifer Bunsa holds a degree in design from Harvard University and is a practicing designer. Her professional experience in design supports representation in design disciplines and contributes to the Board's capacity in arts, design, and planning related review. Current Art in Public Places Board: Appointments AIPP Board Member Degree Profession Alt. At -Large Jacqueline Roch M.S. Art Education, B.F.A. Fine Arts / Education At -Large Maria A. Napoles B.S. Psychology Fine Arts / Exhibits At -Large Juan Valadez B.A. Art Museum Curation, Rubel! Museum At -Large Odalys De Yurre MDCPS Alternate Patricio Suarez Ed.S., M.A., B.A. District Supervisor of Performing Arts, Miami -Dade County Public Schools Mayor Dr. Denise Wallace Juris Doctor Academia, Cultural Initiatives, Policy District 1 Nelson Delgado B.A. Theater / Acting Financial Analyst District 2 Olga Granda (Vice Chair) B.A. Religion; Studies in Art History and Languages Fine Art, Antiques, Real Estate District 3 Vacant District 4 Christina Cuervo B.S. Business Administration Real Estate Development District 5 Gary Feinberg B.S. Psychology & Art History Real Estate If you have any further questions related to this request, please contact Indra Alam, Public Art Manager at ialam(a�miamigov.com cc. David Snow, Director Sevanne Steiner, AICP, CNU, Assistant Director of Planning Erica Lee, MSW, MPA, Assistant to Director — Planning Danielia Zegarra, Special Projects Coordinator Raymond Pereira, Assistant City Attorney Todd B. Hannon, City Clerk PLANNING AND ZONING DEPARTMENT DIVISION OF ART IN PUBLIC PLACES ART IN PUBLIC PLACES BOARD APPLICATION CD The Art in Public Places Board Members receive no compensation for their service on the Board; but are entitled to reimbursement for necessary and proper expenses incurred in performing duties on the Board (e.g. parking for AIPP board meetings and conference(s)). Board members may be required to attend local and or national public art conferences. X i Jennifer Bunsa First Name Last Name 24 SW 28th Road Miami FL 33129 Address City State Zip jen@'bunsa.studro fit 7.599.0333 786-622-1515 Email Address Phone (Home) (Phone (Office) Interior Designer Occupation Art in Public Places Board members shall have an interest and knowledge of the visual and performing arts, and the artistic development of the city. Eight (8) Board members must be knowledgeable and have a Bachelor's, Master's or Doctorate Degree from an accredited university or college in one of the following identified fields: Please check the one that pertains to you. ❑ Fine Arts or Museum Curation ■ Architecture or Landscape Architecture ❑ Urban Planning or Urban Design ❑ Graphic or Product Design c- `r1 N ❑ Art Education, Art History or History of Architecture ❑ Construction Management or Red>Estate • —10 y - 3 �^J ❑ Finance ❑ Music -„.;i Please check the degree(s) that pertain to you. 2T"- it 1 Doctorate • Masters Bachelors rn CO :71 CA) One (1) Board member and (2) alternate shall have an interest in the visual and performing arts. Neither of these members is required to have a Bachelors, Master, or Doctorate Degree. ❑ Interest in the Visual and Performing Arts SHORT STATEMENT OF QUALIFICATIONS (If you require additional space, attach additional pages.) 1. Describe the qualities, experience, expertise and abilities that you possess that would make you an effective Art in Public Places board member that will act in the public interest. As a fourth generation Miamian, I have a unique perspective into the rich cultural diversity and history of the City of Miami. I am an interior designer who actively works with clients on building their art collections. I regularly attend local gallery openings. PlanningIAIPPi AIPP Board Application 12131/2024 Page 1 of 5 2. Describe your educational background and or general knowledge of the Arts. I studied Architecture in College (University of Florida) as well as Graduate School (Harvard University) and have a Masters degree in Architecture. In school I was always intrigued by the overlap of the arts (decorative arts, visual arts, and film) with Architecture, and, more specifically, interior spaces. I studied extensively at the Carpenter Center at Harvard and took many film classes there. In my professional career, I often work with artists on custom commissions for client projects. 3. Describe any prior community or personal involvement that you may have had that demonstrates interest in the Visual Arts, Public Art or the Performing Arts. I regularly attend local gallery openings and am involved with local arts communities as well. I am serving on the Gala Committee for YMU (Young Musicians Unite) which champions the performing arts and music education for young people in underserved communities. I also attend fundraisers for organizations like Locust House, 4. What is it about the Art in Public Places Board that is compatible with your experience and of specific interest to you, and why? r-.., I truly believe in the importance of art and culture and the potential positive impact it can have on the community. �1 1 believe that my experience working with corporate art collections and private clients can be beneficial to the City of Mia[rFri am Xi rn I look forward to collaborating with others who share my passion for the arts.'-,, r �1 c CJ 5. If appointed, what specific goals would you like to see the Public Art Board achieve, and why? How would you suggest accomplishing this? I would Pike to participate in a collaborative team with the end goal being to enrich and highlight the city's diverse cultural heritage and use art as a catalyst for positive change. REQUIRED ATTACHMENTS r Resume ❑ Proof of Education i No more than two (2) letters of recommendation E Real Property Disclosure Form PlanninglAlPPI AIPP Board Application 12/31/2024 Page 2 of 5 CITY CODE SECTION 2-612(A) STATES, NO BOARD MEMBER SHALL ENTER INTO A CONTRACT OR TRANSACT ANY BUSINESS WITH THE CITY OR ANY PERSON OR AGENCY ACTING FOR THE CITY, OR SHALL APPEAR IN REPRESENTATION OF ANY THIRD PARTY BEFORE ANY BOARD, COMMISSION OR AGENCY OF WHICH SUCH PERSON IS A MEMBER. HAVE YOU ENTERED INTO A CONTRACT OR ARE YOU CURRENTLY TRANSACTING ANY BUSINESS WITH THE CITY OR ANY PERSON OR AGENCY ACTING FOR THE CITY? DYES x❑ NO Note: This restriction can be waived for a particular transaction or transactions only by a four -fifths (415t4) affigyative vote of the members of the City Commission. ri ct 2-1 e7 Fri 17 0 i have read and understand the qualifications for members that are set forth in Sec. 62-63 of the City fode, anrd hereby:. certify that: 1. I do not have anyinterest in theprofits or emoluments of anycontract, work, or service for e}ci t-� � job,� �'" 2. I am in a position to represent the public interest, and do not have any personal or private intpsts``&ely to conflict with the public interest. =� 3. I do not hold any elective office in any governmental authority in the county or the city. 4. As a member of the Art in Public Places Board I agree to participate in at least one seminar on Public Art to be held in Florida, and approved by the city, during the course of each calendar year that I remain a member or alternate member of the Art in Public Places Board. 5. As a member of the Art in Public Places Board I may be required to attend a city approved state or national Public Art conference once a year. 6. I acknowledge that I am subject to removal from the board if I fail to meet this requirement each and every year after assuming board membership or alternate membership. 7. As a prospective appointee I am subject to a personal appearance before the city commission, to afford the city commission an opportunity to ascertain my proficiency in the English language, educational background and general knowledge of Public Art. Please note: Art in Public Places Board members Applicants shall reside, own property or work within the City of Miami. Should I fail to meet any of these requirements, I agree to immediately notify the city clerk. I agree that if I were to become a candidate for elective political office during my term and qualify as a candidate for elective political office, such qualification shall be deemed a tender of my resignation from the board. I have read, understand and agree to comply with Section 2-611 of the Miami City Code which prohibits me from entering into any contract or transact any business with the city or any person or agency acting for the city, or from appearing in representation of any third party before any board, commission or agency of which I am member. I also understand that prohibition upon activity which is set forth above remains in effect for a period of two years after I have left city service. I have read, understand and agree to comply with Section 2-613 of the Miami City Code which prohibits me from accepting, directly or indirectly, from any person, company, firm or corporation to which any purchase order or contract is or might be awarded, any rebate, gift, money or anything of value whatsoever, except where given for the use and benefit of the city. JB Initial Planning/AIPP/ AIPP Board Application 12131/2024 Page 3 ai 5 I agree to comply with all financial disclosure requirements of the City, the County and the State including the requirements set forth in Section 2-11.1 of the Miami -Dade County Code, and Florida Statutes Sec. 112-3145. I agree to comply with all ethics course requirements of City of Miami Code Section 2-38. I acknowledge that the code of ethics of Miami -Dade County shall apply to me as a member or alternate member of the Art in Public Places Board and hereby agree to abide by all the provisions thereof. l have read, understand and agree to comply with Section 2-613 of the Miami City Code which prohibits me from accepting, directly or indirectly, from any person, company, firm or corporation to which any purchase order or contract is or might be awarded, any rebate, gift, money or anything of value whatsoever, except where given for the use and benefit of the city. For additional information on Code citations, please visit the website of the Office of the City Attorney at http:I1www. miamigov.comfcityattorney/index.html for Internet links to citations. I recognize that membership on the Art in Public Places Board requires my regular attendance and participation at board meetings. I hereby certify that all information in this application is complete, truthful, and accurate to the best of my knowledge and that I have read and understand the qualifications and conditions of membership listed in this application. x YES Print Marne: Jennifer Bunsa Na Signature: Date: 04.07.2026 171 0 rn rn Please complete this form and submit to: Office of the City Clerk City of Miami 3500 Pan American Drive Miami, FL 33133 Attn: Nicole N. Ewan For additional information on the Art in Public Places Board and or the Art in Public Places Ordinance please contact Indra Alam, Planning and Zoning Department at 305.416.1096 or via email at lalam@miamigov.com TO BE COMPLETED BY STAFF CD: AP: Planning/AIPP/ A!PP Board Application 12/3112024 Page 4 of 5 OF CITY OF MIAMI Print Form ; = x t REAL PROPERTY DISCLOSURE FORM (IN CONFORMANCE WITH SEC. 2-615 OF THE CITY CODE) k OR50* Legal Description (Lot 7, Primose Sec 4, PB 52) Common Address (123 North East 54th St) Title Legal/Equitable Ownership Whole/In Part Zoning Class Present Use FLAGLER RESUB 24 SW 28TH ROAD MIAMI, FL 33129 LEGAL WHOLE 0100 residence fn -' 9: 1 n=' I , i t l_ J. ...IV _yjd rIEilr f'ti ,,ill a I� a Al Note: You are not limited to the space on the lines in this form. Attach additional sheet(s) if necessary. OATH I, Jennifer Bunsa do solemnly swear that the above is a true and accurate statement of my interests in real property located within corporate limits of the CITY OF MIAMI or 500 feet beyond the corporate limits of the CITY OF MIAMI. NAME:(Please Print): Jennifer Bunsa TITLE/POSITION WITH CITY OF MIAMI: NAME OF BOARD/COMMITTEE (lfapplicable): Art Public Places Board SIGNATURE: L-I�--. DATE: 04.07.2026 Sworn to (or affirmed) and subscribed before me by means 7#- day of iRi 1 , 20 2 G , by J.eh of t[+j�physical presence or I online notarization, this i -ec_ of m 5G, (Name of erson signing and his/her-t' e (public officer, trustee or personal representative) WITNESS my hand and official seal. jA lit IL +� j�" A. riot!' State of �o!'�" NO ARYLIC, STATE OF FLORIDA y� jr,...)l le Cr.' arl County of r (,�,4l . J-��G1r r (Name of Notary Public: Print Stamp, or Type as Commissioned) me, or NOTARYPUBLIC ❑ Personally Known to V2 SEAL OF OFFICE: i_ � 1.-+ L Produced Identification: I1 t C'1 5- '"' 1 i ti"••t NIGGLE EWAN +� t"\ Nota Pubtic - State of Fiorfda '� ` Commission M HH 509714 �•'�•...., .. y CommExpires Jun 19, 2928 Bonded through National Notary Assn. 1 (Type of Identification Produced) 1 ❑ DID Take an Oath, or I 0/DID NOTTake an Oath 1 PLANNING AND ZONING DEPARTMENT DIVISION OF ART IN PUBLIC PLACES ART IN PUBLIC PLACES BOARD APPLICATION CD The Art in Public Places Board Members receive no compensation for their service on the Board; but are entitled to reimbursement for necessary and proper expenses incurred in performing duties on the Board (e.g. parking for AIPP board meetings and conference(s)). Board members may be required to attend local and or national public art conferences. LISSETTE GARCIA ARROGANTE First Name Last Name 1510 SW 21 STREET MIAMI FL 33145 Address City State Zip LISSETTEARROGANTE@GMAIL.COM 305-205-8079 Email Address Phone (Home) (Phone (Office) ARTS AND CULTURE PROFESSIONAL Occupation Art in Public Places Board members shall have an interest and knowledge of the visual and performing arts, and the artistic development of the city. Eight (8) Board members must be knowledgeable and have a Bachelor's, Master's or Doctorate Degree from an accredited university or college in one of the following identified fields: Please check the one that pertains to you. ❑ Fine Arts or Museum Curation ❑ Architecture or Landscape Architecture (7) �� ❑ Urban Planning or Urban Design ❑ Graphic or Product Design - - l i C ( • Art Education. Art History or History of Architecture ❑ Construction Management or Real Estate v.- 1 Finance ❑ Music a Please check the degree(s) that pertain to you. cs CD Doctorate [ Masters ❑ Bachelors One (1) Board member and (2) alternate shall have an interest in the visual and performing arts. Neither of these members is required to have a Bachelors, Master, or Doctorate Degree. ❑ Interest in the Visual and Performing Arts SHORT STATEMENT OF QUALIFICATIONS L (If you require additional space, attach additional pages.) 1. Describe the qualities, experience, expertise and abilities that you possess that would make you an effective Art in Public Places board member that will act in the public interest. I HAVE OVER 20 YEARS OF PUBLIC, PRIVATE, AND NON PROFIT EXPERTISE IN THE ARTS. I HAVE EXPERIENCE WORKING WITH LOCAL AND INTERNATIONAL VISUAL ARTISTS AS THE DIRECTOR OF TOURISM AND CULTURE FOR THE CITY OF MIAMI BEACH, I OVERSAW CULTURAL AFFAIRS, ART IN PUBLIC PLACES, AND CULTURAL ARTS COUNCIL FROM 2020 THROUGH JUNE 2026. I WAS PREVIOUSLY THE DIRECTOR OF CULTURAL RESOUCES FOR THE CITY OF SAVANNAH, GA, Planning/AIPP/ AIPP Board Application 12/31/2024 Page 1 of 5 2. Describe your educational background and or general knowledge of the Arts. I HAVE A BACHELORS OF ART HISTORY AND A MASTERS OF PUBLIC ADMINISTRATION. I AM A SEASONED ARTS AND CULTURE LEADER WITH AN IN-DEPTH UNDERSTANDING OF THE VALUE OF ARTS AND CULTURE AS AN ECONOMIC DRIVER. I HAVE OVERSEEN MULTPILE MUNICIPAL PUBLIC ART PROJECTS AND CURATED EXHIBITIONS. 3. Describe any prior community or personal involvement that you may have had that demonstrates interest in the Visual Arts, Public Art or the Performing Arts. I HAVE AN EXTENSIVE CAREER WORKING IN THE VISUAL AND PERFORMING ARTS. ASIDE FROM MY PROFESSIONAL EXPERIENCE. I AM A MEMBER OF THE PEREZ MUSUEM OF ART AND MAINTAIN INVOLVEMENT IN THE LOCAL AND NATIONAL ARTS COMMUNITY BY ATTENDING EXHIBTIONS AND VISITING ARTIST STUDIOS. 4. What is it about the Art in Public Places Board that is compatible with your experience and of specific interest to you, and why? I HAVE PRIOR EXPERIENCE IN OVERSEEING ART IN PUBLIC PLACES FOR THE CITY OF MIAMI BEACH AND CITY OF SAVANNAH. I WOULD LIKE THE OPPORTUNITY TO SHARE MY KNOWLEDGE !N THE COMMUNITY I WAS BORN, RAISED AND CURRENTLY LIVE IN. r 5. If appointed, what specific goals would you like to see the Public Art Board achieve, and why? How woUldl you suggest accomplishing this? I WOULD LIKE TO SHARE MY KNOWLEDGE AND EXPERTISE WITH THE CITY OF MIAMI'S AIPP PROGRAM, AND BRING ATTENTION AT AN INTERNATIONAL SCALE, SIMILAR TO SISTER CITIES MIAMI AND CORAL GABLES HAVE. REQUIRED ATTACHMENTS IT Resume p Proof of Education r No more than two (2) letters of recommendation I Real Property Disclosure Form Planning/AIPP/ AIPP Board Application 12/31/2024 Page2of5 CITY CODE SECTION 2-612(A) STATES, NO BOARD MEMBER SHALL ENTER INTO A CONTRACT OR TRANSACT ANY BUSINESS WITH THE CITY OR ANY PERSON OR AGENCY ACTING FOR THE CITY, OR SHALL APPEAR IN REPRESENTATION OF ANY THIRD PARTY BEFORE ANY BOARD, COMMISSION OR AGENCY OF WHICH SUCH PERSON IS A MEMBER. HAVE YOU ENTERED INTO A CONTRACT OR ARE YOU CURRENTLY TRANSACTING ANY BUSINESS WITH THE CITY OR ANY PERSON OR AGENCY ACTING FOR THE CITY? •• + o YES El NO c_- Note: This restriction can be waived for a particular transaction or transactions only by a four -fifths (4/5ths) affirmative vote of the members of the City Commission. I have read and understand the qualifications for members that are set forth in Sec. 62-63 of the City Code, and hereby certify that: 1. I do not have any interest in the profits or emoluments of any contract, job, work, or service for the city. 2. I am in a position to represent the public interest, and do not have any personal or private interests likely to conflict with the public interest. 3. I do not hold any elective office in any governmental authority in the county or the city. 4. As a member of the Art in Public Places Board I agree to participate in at least one seminar on Public Art to be held in Florida, and approved by the city, during the course of each calendar year that I remain a member or altemate member of the Art in Public Places Board. 5. As a member of the Art in Public Places Board I may be required to attend a city approved state or national Public Art conference once a year. 6. I acknowledge that I am subject to removal from the board if I fail to meet this requirement each and every year after assuming board membership or alternate membership. 7. As a prospective appointee I am subject to a personal appearance before the city commission, to afford the city commission an opportunity to ascertain my proficiency in the English language, educational background and general knowledge of Public Art. Please note: Art in Public Places Board members Applicants shall reside, own property or work within the City of Miami. Should I fail to meet any of these requirements, I agree to immediately notify the city clerk. I agree that if I were to become a candidate for elective political office during my term and qualify as a candidate for elective political office, such qualification shall be deemed a tender of my resignation from the board. I have read, understand and agree to comply with Section 2-611 of the Miami City Code which prohibits me from entering into any contract or transact any business with the city or any person or agency acting for the city, or from appearing in representation of any third party before any board, commission or agency of which I am member. I also understand that prohibition upon activity which is set forth above remains in effect for a period of two years after I have left city service. I have read, understand and agree to comply with Section 2-613 of the Miami City Code which prohibits me from accepting, directly or indirectly, from any person, company, firm or corporation to which any purchase order or contract is or might be awarded, any rebate, gift, money or anything of value whatsoever, except where given for the use and benefit of the city. Initi Planning/AIPP/ AIPP Board Application 12/31/2024 Page 3 of 5 I agree to comply with all financial disclosure requirements of the City, the County and the State including the requirements set forth in Section 2-11.1 of the Miami -Dade County Code, and Florida Statutes Sec. 112-3145. I agree to comply with all ethics course requirements of City of Miami Code Section 2-38. I acknowledge that the code of ethics of Miami -Dade County shall apply to me as a member or alternate member of the Art in Public Places Board and hereby agree to abide by all the provisions thereof. I have read, understand and agree to comply with Section 2-613 of the Miami City Code which prohibits me from accepting, directly or indirectly, from any person, company, firm or corporation to which any purchase order or contract is or might be awarded, any rebate, gift, money or anything of value whatsoever, except where given for the use and benefit of the city. For additional information on Code citations, please visit the website of the Office of the City Attorney at http://www. miamigov.com/cityattorney/index.html for intemet links to citations. I recognize that membership on the Art in Public Places Board requires my regular attendance and participation at board meetings. I hereby certify that all information in this application is complete, truthful, and accurate to the best of my knowledge and that I have read and understand the qualifications and conditions of membership listed in this application. DYES ❑ NO Print Name: LISSETTE GARCIA ARROGANTE Signature: Date: 2026 { Please complete this form and submit to: Office of the City Clerk City of Miami 3500 Pan American Drive Miami, FL 33133 Attn: Nicole N. Ewan For additional information on the Art in Public Places Board and or the Art in Public Places Ordinance please contact Indra Alam, Planning and Zoning Department at 305.416.1096 or via email at Ialam@miamigov.com TO BE COMPLETED BY STAFF CD: AP: Planning/AIPP/ AIPP Board Application 12/31/2024 Page 4 of 5 WITNESS State Cou NOTAQY.IIau(: SEAL �4 OF M'9 u 3 '`°R'°P (IN CITY OF MIAMI Print Form REAL PROPERTY DISCLOSURE FORM CONFORMANCE WITH SEC. 2-615 OF THE CITY CODE) Legal Description (Lot 7, Primose Sec 4, PB 52) Common Address (123 North East 54th St) Title Legal/Equitable Ownership Whole/In Part Zoning Class Present Use 1,6f 3,t, Osaz-+- (4 JYY s, f8 m-i i 0 sW 21 Cbt al" t-1 .(, ui('ttLc rifoccifix P. I, Note: You are not limited to the space on the lines in this form. Attach additional sheet(s) if necessary. -r1 f iaaLei/A OATH %—l-C do solemnly swear that the above within corporate limits of the CITY NAME:(Please Print): TITLE/POSITION WITH CITY OF MIAMI: NAME OF BOARD/COMMITTEE (If applicable): SIGNATURE: DATE: Sworn to (or affirm d) and subscribed it day of Juitt (FIRST, MIDDLE, LAST NAME) is a true and accurate statement of my interests in real propertylocated OF MIAMI (r5or500 feet beyond the corporate limits of the CITY OF Lls. i•- , 04,4449Vrt MIAMI. this M1 on R.6 i i *1u9 o V i gp sence or online notarization, Aff0 I. l.. i before me by means of E .hysical pr , 20 LO , by LISS' ,ill. i.f of my my hand and official seal. V1 i r ) (Nam- 7(11rnin.. d his/her title (p • is officer, trustee 1 or personal representative) NITA•YPUB IC, STATE OF FLORIDA It �NI , f i'i- M of 1 " \ 1 �� l ` ik4 (Name of Notary ' ublic: Print, Stamp, or Type as Commissioned) or rl C� �Q 1 AI 1 / 1 _ I I I a F p 4Ggi.. MYRIAM E. GARRETT /• ' Notary Public • State of Florida „VIVO Commission B HH 526553 asvti My Comm. Expires Feb 13, 2023 Bonded through National Notary Assn. ❑ ersonally Known to me, I Produced Identification: P ❑ DID Take an Oath, or (Type of Identification Produced) ❑ DID NOTTake an Oath