Shantell Mitchell 2020DocuSign Envelope ID: B7EOAD6D-EDBD-403C-8258-C5899BB6F0FD
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OUTSIDE EMPLOYMENT STATEMENT"
For foil-me county and Municipal ~6,
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Ful-time county including Public Heath Trust) and municipal employees engaq@ th all}sis a,pent must tile an annual disclosure report
by July 1st of each year, in accordance with Section 2-11.1()(2) of the Miami-Dade County Code.
MIAMl·DADE. &III
Disclosure for Tax Year Ending 'Last Name First Name Middle Name/Initial
2020 Mitchell Shantell L.
Mailing Address - Street Number, Street Name, or P.O. Box
2423 SW 147 Ave #761
City, State, Zip
Miami FL 33185
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. D
Filing as an Employee (check one)
[] county [] Public Health Trust E] Municipal City of Miami Beach
(Municipality)
Department Division
Police Community Affairs
Position or Title Employee ID Number I Work telephone
Sergeant 177 45 (305) 673-7000
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 Nature of the Total Amount of Money or
of the Source of Outside Income Work Performed Compensation Received
Fitnominal Change Retail & Fitness 0
I hereby swear (or affirm) that the information above is a true and correct statement.
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sin#tr resn iisi
6/16/2023 I 1:30 PM EDT
Date signed
RECEIVED BY ELECTIONS DEPARTMENT:
D Hardcopy
[] Electronic Uopy
RECEIVED
JUN 27 2023
CITY OF MIAMI BEACH
OFFICE F THE CITY CLERK
OFFICE USE ONLY Accepted: Y / N Deficiency: Processed Date/initials: Scanned Date/Initials: _
138_01-22 COE 2016