Exhibit 305 — USA v. Alexandra Acosta (Dkt. 81-27, S.D. Fla.)

Record facts

U.S. District Court for the Southern District of Florida · No. 0:23-cr-60170-RNS · Doc. 81-27 · 2024-06-14 · Docket on CourtListener

Full text

DEPT, OF PROFESSIONAL STANDARDS RECEIVED
JAN 7 4 2017
COLONEL JOHN DALE DEC 22 2016

BROWARD SHERIFF'S OFFICE
OFF-DUTY EMPLOYMENT FORM

MAJOR DAVIO R. HOLMES

| Alexandra Acosta ,CCN _ 17044 _ request that | be granted permission to accept

Print /Type Full Name
off-duty employment for the year 2017 The following Is a description of the work | 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 SW 450th Av Suite 1100, Pembroke Pines, FL 33028

‘Telephone 954-237-0400 Work Days Varies Work Hours Varies

Job Description Real Estate Sales

(If additional space ts 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? CYes NO

(if yes, provide a detailed summary in the space above)

| understand if this request is approved, it is VALID ONLY for the employer, employer's address, telephone number, type of work
and work schedule outlined in this form. | also understand that off-duty employment is a 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. |
agree that | will obtain and maintain all appropriate State, County, and or City approvals, licenses, etc., 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.

| 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 do so may result in revocation of this off-duty employment
request and/or disciplinary action.

(2](s} lg Savth Broward ‘Deputy Shariff

Command "Job Title

ie

Unit Supervisor a A Z/ 5/ Ib 8 rooroves 1 Disapproved
L__BiGnature [OAR Date wa
Shift Supervisor Sct. David Frank 11092 Alir | af !4 [to Approved 0 Disapproved

Signature Date 1.
N 16938
Div Cmdr/Dir Capt. Danzell Brooks, CC YF Approved L] Disapproved
Signature Dae
Regional Cmdr Major David R. Holmes #8714 u Ww ((¢ a ecvsnes 1 Disapproved
Signature Date

Bureau Cmdr O) Approved O Disapproved

yf Ns
NC A olen ccn# 14487 ZF 27 a
Dept Exec Dir a ~~ Approved 1 Disapproved
is Signature Dale
Col t / le
SherifffDesignee el John Date #16920 Ne vd 7 R Approved (| Disapproved

Signature , Date

BSO RP#45 (Revised 04/15)

File and source

File

gov.uscourts.flsd.654235.81.27.pdf

Size

165,335 bytes

SHA-256

40cd0780c9afde75c079644a9f223385e727ca44e034c32000b8d414e8a83fc2

Our copy

gov.uscourts.flsd.654235.81.27.pdf

Original

PACER (login required)