Carlos Munoz Outside Employment StatementMIAMI4DADEOUTSIDE EMPLOYMENT STATEMENT
EM 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
2016 Munoz, Carlos A.
Mailing Address — Street Number, Street Name, or P.O. Box
8197 West 36 Ave. #2
City, State, Zip
Hialeah, FI. 33018
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 one)
❑ County ❑ Public Health Trust 0 Municipal City of Miami Beach
(Municipality)
Department
Division
Parks & Recreation
Recreation
Position or Title
Employee ID Number
Work telephone
Recreation Program Supervisor
15420
(786) 236-2280
Please list the sources of outside employment (including self-employment), the nature of the work, and the total amounts of money or other
compensation you received for each source of outside employment. If no income or compensation was received from a particular outside
employment, enter zero (0) for that organization in the section below. If continued on a separate sheet, check here. ❑
Name and Address
of the Source of Outside Income
Nature of the
Work Performed
Total Amount of Money or
Compensation Received
Miami Beach P.A.L. - 999 11 Street Miami
Beach, FI. 33139
Bookkeeping
$ 440.00 / week
I hereby swear (or affirm) that the information above is a true and correct statement.
1��_
Signature of Person Disclosing elf
Date signed
OFFICE USE ONLY Accepted: Y / N Deficiency:
13801-22 COE 2016
RECEIVED BY ELECTIONS DEPARTMENT:
❑ Hardcopy
❑ Electronic Copy
Processed Date/Initials: Scanned Date/Initials: