Jeysson Marin 2018 MIAmi.DADE 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 A`.
Mailing Address-Street Number,Street Name,or P.O.Box J
3S0 0 sw 112 - vl p< k9T V44-
City,State,Zip
Miami 55A S
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 MkANV�t 16fPcCA-
(Municipality)
Department Division
peAnzitA vn s-h€-e,4 . - 4141 .
Position or Title Employee ID Numbe Work telephone
PanzM9 MA✓ 1e h t 20063 30S —47`j—®gc3i
0731
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
Utn TED P A -(,EI s viC.E co1/4raE t No 1.1 SO#'r
Liss +1.a►n
/340 rv� ZStti ST Q K ,,c„es '[D E 0kA-6ovNb I€1 • UDO.fo
M;AA/6 F1. 33122 r etiY TeAY•
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 CO
OW2-1/ I "
Date signed
OFFICE USE ONLY Accepted: Y / N Deficiency: Processed Date/Initials: Scanned Date/Initials:
138_01-22 COE 2016