Melissa Rosa 2014 MIAMI•DADE OUTSIDE EMPLOYMENT STATEMENT
COUNTY For Full-time County and Municipal Employees
Full-time County(including Public Health Trust)and municipal employees engaging in outside employment must file an annual disclosure report
by July 1st of each year,in accordance with Section 2-11.1(k)(2)of the Miami-Dade County Code.
Disclosure for Tax Year Ending Last Name First Name Middle Name/Initial
2014 051- MO i IS. -A
Mailing Address-Street Number,Street Name,or P.O.Box
-Sq/ - C) Al(J . — .7 00-'-'-Ths--v--.
City,State,Zip ID Number
1"--4/1 I C. 1 kN L___ , C,_) L5 ZOLt 5 e .
If your home address is exempt from public records pursuant to Florida Statutes§119.07,please see note on the following page and check here.❑
Filing as an Employee(check ore)
❑ County/Public Health Trust unicipal Ci CD� V i Q A I� ecL-
(Municipality)
Department Division
Cc \ 1'or - c e Cc - C®1,-,19 t eA -c
Position or Title Work telephone
Ccde Cc -j71 J.'cnCe °Fe/cc —CD-1''D- 'l0(1)C
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,check here. ❑
Name and Address Nature of the Work Performed Amount of Money or
of the Source of Outside Income Compensation Received
1.--c-c,C EGeN , L'\-), r ei1 JS -T--IVc Fr--04u )c fvc%t 454- (DO g
-700 TJ'J 11 z.."" Ailt De c I— c.r L
eN 1,'g nn i' �L 3 l '-1
I hereby swear(or of' )that the information above is a true and correct statement. RECEIVED BY ELECTIONS DEPARTMENT:
❑ Hardcopy
❑Electronic Copy
A APIA
Sign. r: , •e ,1 IT . ing _':l i :II jr) n,'.' '",. ' M
.J ) -3 I ) ?,C :g Wd CIAJ giOZ
Date signed
OFFICE USE ONLY Accepted: Y/ N Deficiency: Processed Date/Initials: Scanned Date/Initials:
138_01-22 COE 2015