Pefico Prachiakol 2019MIAMl·DAD E. EIII 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
Paca Ro Peeo - 2019 0Oo
Mailing Address - Street Number, Street Name, or P.O. Box
763 /. M Mc, Ped o7 . -4f 32z
City, State, Zip -- EL 3332/ 1?ac ,
I
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)
C;Ty 0 M' · Beaci [] county [] Public Health Trust ['] Municipal kM
7 (Municipality)
Department er./ea PeccoE oa esuer É,ge
Position or Title i ,_ Employee ID Number Work telephone
;rev'? I 1742 (3osc3qi
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
ci7y gr HollywoD Pul afery /2o0o o pi er. },I/ DQcea es@us #ollo o c;Ty oh
I
I hereby swear (or affirm) that the information ove is a true and correct statement. RECEIVED BY ELECTIONS DEPARTMENT:
D 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