Loading...
Elvis Rodriguez 2019MIAMl·DADE- EI7 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 fol4vE 2019 First Name { lo Middle Name/Initial Mailing Address - Street Number, Street Name, or P.O. Box l 0 s00 91 City, State, Zip 3os Y, 334 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 O Public Health Trust [wumniceial 04a ! !Ai Bwch I (Municipality) Department Division keseu Fo Oe4 Position or Title 9u+ E Employee ID Number Work telephone (8%44 36- 73-2%/4 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 Nature of the Total Amount of Money or of the Source of Outside Income Work Performed Compensation Received rty ck a, runt-l 'ks4v4, p22rw ' }„.O pe to 36of Re,dg os¢; sh ew} ob KA pelt , Rau. Fl j L,o A lA , , I . I hereby swear (or affirm) that the information above is a true and correct statement. Date signed RECEIVED BY ELECTIONS DEPARTMENT: D Hardcopy [ Electronic Copy OFFICE USE ONLY Accepted: Y I N Deficiency: Processed Date/Initials: Scanned Date/Initials: _ 138_01-22 COE 2016 Received 27 August 2020 Office of the City Clerk