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Andres Asion Minority Report MIAMI BEACH DIVERSITY STATISTICS REPORTING Name: gndres O ,iov • pif/on deib • a rd Board / Committee. � � . Appointment Date: i Z /7 /5- Pursuant to City of Miami Beach Ordinance 2009-3632, the City is required to annually prepare and present a report to the City Commission identifying the City's diversity statistics. This form allows board and committee applicants and members to voluntarily self-identify their race, ethnicity, disabled status and gender. Please check the appropriate box for each category: Gender: Male Female Ui Race/Ethnic Categories What is your race? African-American/Black Caucasian/White Asian or Pacific Islander I N tive-American/American Indian 1.10ther— Print Race: \«Ar•;(-- Do you consider yourself to be Spanish, Hispanic or Latino/a? Mark the "No"box if not Spanish, Hispanic, Latino/a. N LI Yes • Do you consider yourself Physically Disabled? No Yes • C:\Users\CENTFraN\AppData\Local\Microsoft\Windows\Temporary Internet Files\Content.Outlook\NP4J9CNX\BC minority information form 05-20-13 FINAL.doc Updated: Monday,January 26,2015