Gabriel Benitez 2019• M IA l'l'I-DADE . EI
O U T S ID E E M P L O Y M EN T S TAT EM E N T
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
a0o19 >w ,dz
First Name
G
Middle Name/Initial
O
Mailing Address - Street Number, Street Name, or P.O. Box
6 Go
City, State, Zip
3302
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. O
Filing as an Employee (check one)
O County O Public Health Trust E] Municipal c O F l4 Se Ac
7 (Municipality)
Department Division
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Position or Title Employee ID Number Work telephone
-Fe0A> 023
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
e?:A Oen) C»,
F e GUA, s
Nature of the
Work Performed
ucJoe ?
Total Amount of Money or
Compensation Received
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I hereby swear (or affirm) that the information above is a true and correct statement.
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
Received 27 August 2020
Office of the City Clerk