Juana Tormo Calatayud 2019MIAMI-DADE - EI 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()(2) of the Miami-Dade County Code.
Disclosure for Tax Year Ending Last Name First Name Middle Name/Initial
2019 TORMO CALATAYUD JUANA
Mailing Address - Street Number, Street Name, or P.O. Box
15386 SW 57TH STREET
City, State, Zip
MIAMI, FLORIDA 33193
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)
[] county D Public Health Trust El Municipal MIAMI BEACH
(Municipality)
Department Division
BUILDING CUSTOMER SERVICE CALL CENTER
Position or Title Employee ID Number Work telephone
QUALITY ASSESSMENT COORDINATOR 21892 (305) 673-7610
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. []
Name and Address Nature of the Total Amount of Money or
of the Source of Outside Income Work Performed Compensation Received
I hereby swear (rffir:::ee information above is a true and correct statement.
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Date signed
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RECEIVED BY ELECTIONS DEPARTMENT:
O Hardcopy
O Electronic Copy
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OFFICE USE ONLY Accepted: Y I N Deficiency._ < Processed Date/Initials: Scanned Date/Initials:
138_01-22 COE 2016