Stephanie Benedict 2018MIAMI•DADE OUTSIDE EMPLOYMENT STATEMENT
an For Full-time County and Municipal Employees
ti
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 �Gn e.d I C4— G/) I L° J
Mailing Address - Street Number, Street Name, or P.O. Box
-1 �) 2 ( N Vi i1 -
City, State, Zip
nAia/1) dr*\S 331 G�, °1
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 .E municipal t&44 1 6 Ctk G''i
(Municipality)
Department
;rk /La/ . o e,--
Division
C J S S Q rJ i Ce.
Position or Title
Employee ID Number
Work telephone
rCkncinc(od A�aal r.4- T
1_':� 3
3®s"- (A3 ?
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
Npllvoac) Co m'JAI y ChorG
1'1 ci iJ !sWe- PIC)'7 �°l( woo r%0
co'),11,4 c)
(e A^l(�-
I hereby swear (or affirm) that the information above is a true and correct statement.
of Person Disclosing
g hoII
Date signed
RECEIVED BY ELECTIONS DEPARTMENT:
❑ Hardcopy
❑ Electronic Copy
OFFICE USE ONLY Accepted: Y / N Deficiency: Processed Date/Initials: Scanned Date/Initials:
13801-22 COE 2016
ti