Javier Matias
MI~~ i._
OUTSIDE EMPLOYMENT STA~gI1,~NR PM 2~ 43
For Full-time County and Municipal Employees _ ,_ , , , , : ~ k ~,
FULL-TIME COUNTY ANO MUNK:IPAL EMPLOYEES ENGAGING IN OUTSIDE
EMPLOYMENT MUST FILE AN ANNUAL DISCLOSURE REPORT BY JULY
1ST OF EACH YEAR IN ACCOROWNCE WITH SECTION 2-11.1(x)(2) OF Disclosure for
Tax Year Ending:
THE MwMhDADE COUNTY CODE.
Name: Last
~I ~a"(''~ ~s First
~R~ I ~ (z. Middle
"f"~
Filing as a (check one): ~ Miami-Dade County Employee
[j~Munidpal Employee of: M ISM ~ ~~e~ ~- ,cc_E
Position(Title:
Courrty/Municipal Department: County/Municipai Division:
!f your home address is exempt from public records rsuant
~ Work Telephone:~CJr A~1 t~~
~P"s'
J i`~`~'
to Florida Statutes § 1)9.07, please check here: .
Mailing Address (Street Name and Numbe~ Apt #
. ~~~ W/~5 ~111/G~ /GyJ 1~v~
city _ zi .ode
State ~ r
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Please list the sources of outside employment, the nature of the Work and the amounts of money or other
compensation you received. !f continued on a separate sheet, please check hens:
Name and Address of the Souroe of
Outside Income Nature of the Work
Performed Amount of Money or
Compensation Received
M
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I by swear (or affirm) that the aforesaid information is a true and oornect statement. ~ ~
S n ure of Persop, iscl
(~~ ~~~~ Date Signed
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