Raph Monzó MIAMFDADE 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 MWMhDADE COUNTY CODE.
Name: Last Fi Middle
Filing as a(check one): ❑ Miami-Dade County Employee
RTMunicipal Employee of:
Position Title:
s�. ar-4,04 ` Z�."'4'e
County/Municipal D7 ent: County/Munl 'pal Division:
If your home address is exempt from public records p rsuant Work Telephone:
to Florida Statutes§ 119 07, please check here: 76/O
Mailing Address (Street Name and Number) Apt.#
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: ❑
Name and Address of the Source of Nature of the Work Amount of Money or
Outside Income . Performed Compensation Received
7Z 4
rn
I hereby swear(or affirm)that the aforesaid information is a true and co"I ct statement.
Signature of Person Die osi Date Signed
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