Eugene Egemba 2018 MIAMI•DiADE OUTSIDE EMPLOYMENT STATEMENT
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
2018 661"ei '- � ' U
Mailing Address—Street Number,Street Name,or P.O.Box
'2-1- 6/41- AfERN,itie- ,
City,State,Zip
-- �� 3 ci 3 2
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 : Municipal C:,rI `'`' Now,/ f e --
(Municipality)
Department Division
nive c/ c IAA; &-iit;irt",/e-eizityvor
Position or Title Employee ID Number Work telephone
CV/L -- /'' i 1A.e7 0
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 Nature of the Total Amount of Money or
of the Source of Outside Income Work Performed Compensation Received
ei8A7
L'/fr
I hereby swear(or affirm)that the information above is a true and correct statement. RECEIVED BY ELECTIONS DEPARTMENT:
❑ Hardcopy
❑ Electronic Copy
Signature of Person Disclosing RECEIVED
c,/z- t9 JUN 2 8 2019
Date signed
CITY OF MIAMI BEACH
OFFICE OF THE CITY CLERK
OFFICE USE ONLY Accepted: Y / N Deficiency: _ Processed Date/Initials: Scanned Date/Initials:
138_01-22 COE 2016