David AndersonDocusign Envelope ID:497E4BCC-07B7-48C2-AD6D-05DBF41 F9671
MIAMH:~OE-G57 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 llast Name First Name Middle Name/Initial
22 202z hksrzro)MMD \
Malling Address -Street Number,Street Name,or P.O.Box
67IS50 Qr
City,State,Zip
pi0mi,Foi4 35//
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)
D County □Public Health Trust E]Municipal Ci1y Mui4a'1el(Municipality)
Department DivisioneDeeTVere Diviio)
Position or Title Employee ID Number IWork telephone
iUTew,5T 4613
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
D4vi .4D€?so p8A4 Pao PT?e Rae:won@g"/Gea 6,826q15S»6sT of CoTo Pi fuee RaesMii,Fi4
5-314 3
I hereby swear (or affirm)that the information above is a true and correct statement.
OFFICE USE ONLY Accepted:Y I N Deficiency:Processed Date/initials.
138 01-22 COE 2016
RECEIVED BY ELECTIONS DEPARTMENT:
D Hardcopy
0eonPpICEIVED
SEP 20 2024
TY OF MIAMI BEACHCIrTECICLERKOFFICE.
-Scanned Date/initials.