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Joseph Keit 2018Si nature oiN\4 et Disclosing Date sign d MIAMIDO 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. Middle Name/Initial 2018 Mailing Address — Street Number Street Name, or P.O. Box City, State, Zip ql S ifil 00 ''71 /\)e LJ 41 C.Or c-, ( (1111CP 3 /Or 14 6\. ,561 I .....--- , 1 rom public records pursuant to Florida Statutes §119.07, please see note on the following page and check here. q Filing as an Employee (check one) Health Trust Municipal j (C /1/1 C AA n County n Public (Muni polity) Department riT CA ( 1} a k C' V \ r F ti..Q__ Pilfr Division (-)c )(.,\Q__ Position or Title \ro ‘ \.\ .(6\ .1iir Employee ID Number 1 6 .1 36 Work telephone 305-- (-) "7 3 -7(35 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 t[w section below. If continued on a separate sheet, check here. q Name and Address of the Source of Outside Income Nature of the Work Performed Total Amount of Money or Compensation Received A trAi',- tvw-Pi -t I A NI ) ,--, 1 PJ, C , z.. 0 ) s A- . e—&- 140 i--17y2 c -, t , 0 ,wr. e, doljp--„,, f c;/‘ 0 t)- Fv\ 641 ii ',Mc ,[4 ,-( tlici-5 r) I .1 It(Jo .10 ' \,,i,,v Li Disclosure for Tax Year Ending Last Name S . " First Name C91 If your home address is exe I hereby swear (or affirm) that the information above is a true and correct statement. RECEIVED BY ELECTIONS DEPARTMENT: q Hardcopy q Electronic Copy Scanned Date/Initials: Processed Date/Initials: OFFICE USE ONLY Accepted: Y / N Deficiency: 138_01-22 COE 2016