Mario Pena 2016MIikMIDADE OUTSIDE EMPLOYMENT STATEMENT
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 I Last Name
First Name
Middle Name/Initial
2016 1 Pena Mario David
Mailing Address — Street Number, Street Name, or P.O. Box
17430 NW 81 Avenue
City, State, Zip
Miami, FL 33015
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. ❑
Filina as an Emalovee (check one)
❑ County ❑ Public Health Trust ❑ Municipal City of Miami Beach
(Municipality)
Department
Division
Police Department
Operations Division
Position or Title
Employee ID Number
Work telephone
Police Officer
17423
(305) 673-7776
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 zero (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
AMC Construction & Development Corp
17430 NW 81 Avenue Miami, FL 33015
Home Remodeling Services
$6,000,000
I hereby swear (or affirm) that the information above is a true and correct statement.
Signature of Jerjon Disclosing
OG
Date sii
RECEIVED BY ELECTIONS DEPARTMENT:
❑ Hardcopy
❑ Electronic Copy
OFFICE USE ONLY Accepted: Y / N Deficiency: Processed Date/Initials: Scanned Date/Initials:
138 01-22 COE2016