Arnaldo Bugallo 2021O U T S ID E E M P L O Y M E N T S TAT E M E N T
For Full-tim e C ounty and M unici pal Em ployees
Full-tim e County (including Public Health Tru st) and m unicipal em ployees engaging in outside em ploym ent m ust file an annual disclosure report
by July 1st of each year, in accordance w ith Section 2-11.1(k)(2) of the M iam i-Dade County Code.
Disclosure for Tax Year Ending
2021
City, State, Zip
II your home address is exempt from public records pursuantto Florida Statutes $119.0 7, please see note on th e following page and check here,~
Filing as an Employee (check one)
D County [ Public Health Tru st
Employee ID Number
/5 2 o
Please list the sources of outside em ploym ent (in cl udin g self-emp loym ent), th e nature of the w ork, and the total am ounts of m oney or other
com pensation you received fo r each source of outside em ploym ent. If no incom e or com pensation was re ceived fro m a particular outside
em ploym ent, enter zero (O) for that organization in the section below . If continued on a separa te sheet, check here. D
Total Amount of Money or
Compensation Received
e (or affi rm ) that the inform ation above is a true and correct statem ent.
0, 22
o.e a 7
RECEIVED BY ELECTIONS DEPARTMENT:
D Hardcopy
) estroni %/!cEIVED
JUL 05 2022
C ITY O F M IA M I BEA C H
OFFICE O F THE CITY CLERK
OFFICE USE ONLY Accepted: Y / N Deficiency. Processed Date/initials: Scanned Date/initials:
138_01-22 COE 2016