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CITY OF MIAMI

PUBLIC DISCLOSURE OF FINANCIAL INTERESTS

Subject to City Code Section 2 619)
-

NOTE: As an alternative to the requirements set forth in the above c- ited Code Section, the person filing
this report may provide a copy of the current year's Federal income tax return (See last page for
Instructions).

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LAST NAME FIRST NAME ' MIDDLE INITIAL OFFICE HELD

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RESIDENCE ADDRESS CITY ZIP CODE COUNTY

ASSETS AND LIABILITIES IN EXCESS OF $5,

000

PART A] -ASSETS PART B] -LIABILITIES

ASSETS 000:
OVER.$
5,
DESCRIPTION VALUE Please list below the name and address of every
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person, whether individual or corporation, to
U whom you owe a liability exceeding $ 5, 000,
1 >v 1 1 sw 3 C( A 327 , 1 (r 1̀ and the total amount of indebtedness.
Liability" is defined as any monetary debt or
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1/ obligation owed by you to another person,
cro6, including credit card retail installment accounts;
S 04C $ \ taxes owed; indebtedness on a life insurance
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policy owed to the issuing company; or accrued

income taxes on net unrealized appreciation.
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Name Address
/ of Creditors: Amount- Owed:

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Continued Continued Assets Assets Over Over

$ $5,5,
000: Continued Continued Liabijtjes Liabijtjes NN
tiitors/PLl!
PLl! tiitors/ Owed Owed
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3. 114:if' }.
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HOUSEHOLD GOODS/ PERSONAL EFFECTS 4.

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Household goods and personal effects may be
reported in a lump sum if their aggregate value
exceeds $5,
000. This category includes any of
the following ( if not held for investment
purposes):jewelry.;,
stamp collections; guns and
numismatic properties; art objects; household
equipment and furnishings; clothing; other
household items; and vehicles for personal use.
The aggregate value of my household goods
and personal effects as described above is:

PART PART C]C]- - NETNET WORTH WORTH

NetNet worthworth isis thethe difference difference between between totaltotal assetsassets andand totaltotal liabilities,liabilities, notnot merelymerely thosethose listedlisted inin
PART PART AA( ( above),above), which which have have aa value value inin excess excess ofof$ $5, 5,
000. Please Please enter enter your your net net worth worth asas ofof
December December 31 31 of of the the taxtax year year or or aa more more recent recent date.date.
00 22, ," ". .` ` 33
MyMy net net worth worth asas ofof JJ, , 2020 YOYO was was
$\ $\

PART PART DJDJ- - AFFIDAVIT AFFIDAVIT

The The information information disclosed disclosed dem-and onon any any attachments attachments hereto hereto isis true true and and correct correct toto mymy knowledge.knowledge.

Signa Signa rere ofof PerPer

. .nn Reporti Reporti
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Date Date
QQ

StateState ofof Florida Florida

County. of. age

' age

ofof 22
On On this this the the
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IrIr, ,
2020 iUiU, , before before
Florida,Florida, the,foregging r trutnenttrutnent waswas acknpwledgedacknpwledged by:by:. .
me,me, the the undersigned undersigned Notary Notary Public Public of of the the State State of of

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Name Name ofof person person signing signing andand his/her title ti(tle ( public public officer,officer, trustee trustee oror personal personal representative) representative)

SEAL SEAL OF OF OFFICE: OFFICE:

NOTARY NOTARY PUBLIC,PUBLIC, STATE STATE OFOF FLORIDA FLORIDA

tge tge Personally Personally known known toto me me oror sr.•

sr.•Publi r. Publi r. State State ofof Florida Florida
Produced Produced identification:identification: g6ir ?g6ir ?T,T, m m

TypeType ofof IdentificationIdentification Produced)Produced) scion scion DD711379 DD711379

DID DID take take an an oath oath
2011 2011
4—
DID NOTNOT taketake anan oath.oath.