Jose Perez 2019MIAMI-DADE - Em
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 Pleca s£ A0To)1O
Mailing Address - Street Number, Street Name, or P.O. Box two 5no, 6Oo 4sr042 r 6 , 3s1-
City, State, Zip ,
3316
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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 O· Public Health Trust O Municipal
(Municipality)
Department ha,o so h-<a aaL ß Division
O.. k+(a.a% $
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Position or Title
L[i4. Employee ID Number Work telephone Oea- (337>
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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. O
Name and Address Nature of the Total Amount of Money or
of the Source of Outside Income Work Performed Compensation Received
hat the information above is a true and correct statement. RECEIVED BY ELECTIONS DEPARTMENT:
D Hardcopy
[] Electronic Copy
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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