Yair Chang 2016MIANti-DADE OUTSIDE EMPLOYMENT STATEMENT
�`" �"v 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 Cr � �
Mailing Address — Street Number, Street Name, or P.O. Box
v- 2
City, State, Zip
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 F'1 Municipal
(Municipality)
Department
1�5 (:�4,tq—,AJ
Division
6,r4-�L
ion/or TTitle
Employee ISD Number
Work telephone
rs't
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61 l
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
1 hereby swear (or
Person
Vh4t the information above is a true and correct statement.
/6
RECEIVED BY ELECTIONS DEPARTMENT:
❑ Hardcopy
❑ Electronic Copy
RECEIVED
AUG 12 2022
CITY OF MIAMI BEACH
OFFICE OF i HE CITY CLERK
OFFICE USE ONLY Accepted: Y / N Deficiency: Processed Date/Initials: Scanned Date/Initials:
13801-22 COE 2016