Brad Kaine 2021M IA M l·DADE • ET,
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
2021
Last Name
k.
First Name Middle Name/Initial
~
o».sop fl2.3
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 [ Public Health Trust
Department "„hr
e „„k» D.cd. Work telephone
306-173-71
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
Nature of the
Work Performed
Total Amount of Money or
Compensation Received
L Sus LL (ow?a [h» «oiy ho
fo(r
ove is a true and correct statement.
Date signed
RECEIVED BY ELECTIONS DEPARTMENT:
D Hardcopy
D Electronic Copy
RECEIVED
MAR 15 2022
CITY OF MIAM I BEACH
OFFICE CF THE CITY CLERK
OFFICE USE ONLY Accepted: Y / N Deficiency: Processed Date/initials: Scanned Date/Initials: _
138_01-22 COE 2016