Exhibit 304 — USA v. Alexandra Acosta (Dkt. 81-26, S.D. Fla.)

Summary

A Broward Sheriff's Office off-duty employment form in which Alexandra Acosta requests permission to accept off-duty employment for the year 2016. It lists the business as Keller Williams Realty Partners, with work days and hours both "Vary" and the job description "Real estate sales". The form states that approval is valid only for the listed employer, address, type of work and schedule, and that the request expires on December 31 of each year. It has approval lines for the unit supervisor, shift supervisor, division commander, regional commander and bureau commander, and is stamped Government Exhibit No. 304 in Case No. 0:23-cr-60170-RNS.

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Case 0:23-cr-60170-RNS Document 81-26 Entered on FLSD Docket 06/14/2024 Page 1of1
R

CEIVED
RECEIVED DEPT. OF PROFESSIONAL STANDARDS
DEPT. ORERMIHAP orn natant RECEIVED

WE 28
: COLONEL JOHN DALE AUC 24 16
coconBROWARD SHERIFF'S OFFICE

COLO OEE DUTY EMPLOYMENT FORM

MAJOR DAVID R, HOLMES

| Alexandra Acosta ,CON _ 17044 , fequest that | be granted permission to accept

Print Type Futl Name
off-duty employmént-forthie year 2016. The following is a description ofthe wark | will perform and the days:and times | will be-engaged in

this employment (if consulting or irregular hours, explain).

Business Name: Keller Williams Realty Partners, SW Address: 2000 NW 150th Avé #Suite 1100, Pembroke Pines; FL 33028

Telephone: 954-237-0400 Work Days: Vary Work Hours: Vary

Job Description: Realestate saies.

{if additional space is needed for explanation, provide information on a Separate sheet of paper and-attach to this application):

Does business involve:sale and/or distribution of alcoholic beverages? 0 yes NO
(If yes, provide a detailédé summary in the space above)

f understand if this request is approved, itis VALID ONLY for the employer, employer's address, telephone number, type of work
and work schedule outlined in this form. f also understand that off-duty employment isa privilege and not a right. This will
include employees who sit on external boards and commissions (public, private, or non-profit) whether compensated or not t
agree that | will obtain and maintain all appropriate State, County, and or City approvals, licenses, efc., as applicable. | further
understand that.the Sheriff reserves the right to approve, deny, suspend, and or revoke this request at any time for any reason.

i have read and understand the policies as outlined in section 3.16 of the Sheriff's Policy Manual and agree to abide by them. {

understand that this request expires on December 31" of each year. Once employment is terminated, | must submit an Off-Duty
Termination form (BSO RP#45b). / also understand that my failure to de so may resuit in revocation. of this off-duty employment

request and/or disciplinary action.

Employee Signature, CCN ate Command Job Title:
Unit Supervisor: idis, CCN 14612 Gl ial b Gi Approved 1 Disapproved
iT Signatur ? Date
leutenant Stephani Co: 4
Shift Supervisor: i Witty § -Ag-l lo Approved 1 Disapproved

Signature——_ Oats
; Capt. Danzelt Brooks, CCN 16:

Div. CmdrfDir.: ; EL-B Approved 0) Disapproved

Signature Date
Mejor David R. Holmes #8714 AL ets (1 Disapproved
14487
A

Regional Cmdr-735 oe

ey tot mo gy Se lab, * i Signatur
ae “Lt. Colonel "Bolan, C

Bureau Cmdr.

V cou O Disapproved.

Signature
Golorie! Alvin Pollock, CC
Dept. Exec. Dir: eae Je nase 0 Sisapproved
ities i. 7 Sue Signature.”
SherifffOesignee: . fK Approved D1 Disapproved
Signature

BSO RP#45 (Revised 04/15)

GOVERNMENT
EXHIBIT

CASE
NO, 2260170-CR-RNS

EXHIBIT
NO. 304

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