Rosendo E. Prieto OUTSIDE EMPLOYMENT STATEMENT
MIAM ADE.
®~ For Fufi-time County and Municipal Employees
FULL THNE COUNTY AND MUNICIPAL EMPLOYEES ENGAGING iN OUTSIDE
EMPLOYMENT MUST FlLE AN ANNUAL DISCLOSURE REPORT BY .JULY DISCIOSUr@ fOr
1ST OF EACH YEAR IN ACCORDANCE VUITH~ SECTION 2-11.1(K)(2) OF Tax Year Ending:
THE MIAMI-DADE COUNTY CODE.
Name: last ~ ~~~ First Middle
~a
Filing as a (check one): ^ Miami-Dade County Employee
• ~ Municipal Employee of ~~M 1 ~~"~
Position Title:
~~ • ~L,~ . 11-sr ~~
County/i1Aun'Iripal Department:
~;~.}~o CountylMunicipal Division:
!f your home address R exempt from public reoor~ rsuant Work Telephone:
tQ Florida Statutes § 119.07, please check here: ~ ~~ ro""~ "']000
Mail'mg Address (Street Name and Number] Apt. #
Cry State Tp Code•
1,41 l ~. ~,~-~ ~
Please fist the sources of outside employment, fire nature of the work and the amounts of money or other
compensation you received. If conSnued on a separate sheep please check hens: ^ •
Name and Address of the Source of Nature of the Work Amount of Money or
Outside Income Performed Compensation Received
1 hereby-swear ( affirm) that the aforesaid infomnation is a true and cornea statement.
Signature of n Disclosing Date Signed
~'~' ~~
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