Rafael Ojeda 2010 MIA- OUTSIDE EMPLOYMENT STATEMENT
For Full -time County and Municipal Employees
FULL -TIME COUNTY AND MUNICIPAL EMPLOYEES ENGAGING IN OUTSIDE
EMPLOYMENT MUST FILE AN ANNUAL DISCLOSURE REPORT BY JULY Disclosure for
1ST OF EACH YEAR IN ACCORDANCE WITH SECTION 2- 11.1(K)(2) OF Tax Year Ending: -.
THE MIAMI -DADE COUNTY CODE.
Name: Last First Middle
Filing as a (check one): 0 Miami -Dade County Employee
Municipal Employee of: / 0. .10
Position Title:
County/Municipal Department: County/Municipal Division:
If your home address is exempt from public records pursuant Work Tele hon
to Florida Statutes § 119.07, please check here: 0 I
Mailing Address (Street Name and Number) Apt. #
/y , x.) CO a - lek'
City State Zip Code
Please list the sources of outside employment, the nature of the work and the amounts of money or other
compensation you received. if continued on a separate sheet, please check here: 0
Name and Address of the Source of Nature of the Work Amount of Money or
Outside Income Performed Compensation Received
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I hereby swear (or affirm) that the aforesaid information is a true and correct statement. m
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Signature of P I g Date S' n -t,
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