David Crespo 2016MIAMI - OUTSIDE EMPLOYMENT STATEMENT
mm 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 C � 1164Name
0
Mailing Address — Street Number, Street Name, or P.O. Box
I O`f 2 5w 118 Qc
City, State, Zip
m� m FC, 33186
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 Employee (check one)
® County ® Public Health Trust "Municipal Sty OF Mf40N / 1909c"
(Municipality)
Department
Division
t -12t W
301&- ,jy
Position or Title
Employee ID Number
Work telephone
QE 7E4-
2/9/Z,
3os - 03-7/le
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
/'9fAm DUDE O)L(C-�
gSW20 Ai
fo►gm l F(_ 33121
Aj) 0NC`r /NS"79UC70(Z
301&- ,jy
I hereby swear (or affirm) that the information above is a true and correct statement.
Signature of Person Disclosing
/e9/,-7
Date signed
RECEIVED BY ELECTIONS DEPARTMENT:
❑ Hardcopy
❑ Electronic Copy
OFFICE USE ONLY Accepted: Y / N Deficiency: Processed Date/Initials: Scanned Date/Initials:
13801-22 COE 2016