Stephanie Benedict 2019MIAMI-DADE - ETEI
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
2019 1eeò c} S+epare J o /
Mailing Address - Street Number, Street Name, or P.O. Box V /
11121 A u) 14 \2e.
City, State, Zip
M a , FL 331 q
If your home address is exempt from public records pursuant to Florida Statutes $119.07, please see note on the following page and check here. D
Filing as an Employee (check one)
D County ] Public Health Trust [Municipal 0+4 o f l a a j Re«ch
(Municipality)
Department Division
#a e € C osl o o SeuceC)
Position or Title Employee ID Number Work telephone
{no_ccl 4aalq sh ' al&34 30$-73.7/2¢¢
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 (O) for that organization in the section below. If continued on a separate sheet, check here. D
Name and Address
of the Source of Outside Income
Nature of the
Work Performed
Total Amount of Money or
Compensation Received
H+otl4 w oo) C o a n 0a hy l och 13.17
7o? J Slah &a 7, "!'/"%?/e3Jada4 a «a 4 coohae4 b s e l 4
I hereby swear (or affirm) that the information above is a true and correct statement.
. . . Sign atut of Person Disclosing
Date signed
RECEIVED BY ELECTIONS DEPARTMENT:
[] Hardcopy
[] Electronic Copy
OFFICE USE ONLY Accepted: Y / N Deficiency.> Processed Date/Initials: Scanned Date/initials:
138_01-22 COE 2016