Loading...
Miguel Anchia 2016iNIAfNF� OUTSIDE EMPLOYMENT STATEMENT °'bh.1s For Full-time County and Municipal Employees Full-time County (including Public Health Trust) and municipal employees engaging in outside employment must file an annual disclosure report by July 1st of each year, in accordance with Section 2-11.1(k)(2) of the Miami -Dade County Code. Disclosure for Tax Year Ending Last Name First Name Middle Name/Initial 2016 Anchia Miguel --- Mailing Address — Street Number, Street Name, or P.O. Box 2300 Pine Tree Drive City, State, Zip Miami Beach, FL 33140 If your home address is exempt from public records pursuant to Florida Statutes §119.07, please see note on the following page and check here. ❑✓ Filing as an Emplovee (check one) ❑ County ❑ Public Health Trust El Municipal City of Miami Beach (Municipality) Department Division Fire Department Administration Position or Title Employee ID Number Work telephone Deputy Chief 21989 -1 VVV Please list the sources of outside employment (including self-employment), the nature of the work, and the total amounts of money or other compensation you received for each source of outside employment. If no income or compensation was received from a particular outside employment, enter zm (0) for that organization in the section below. If continued on a separate sheet, check here. ❑ Name and Address of the Source of Outside Income Nature of the Work Performed Total Amount of Money or Compensation Received Tenet Health - Palmetto General Hospital 2001 W. 68th St. Hialeah, FL 33014 Governing Board Member $1,750 I hereby swear (or affir ha a information above is a true and correct statement. Signature of FA Date RECEIVED BY ELECTIONS DEPARTMENT. Hardcopy Electronic Copy OFFICE USE ONLY Accepted: Y / N Deficiency:_ Processed Date/Initials: Scanned OateAnitials: 13801-22 COE 2016