Jose Catasus 2021MIAMI-DADE. OUTSIDE EMPLOYMENT STATEMENT gm 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 First Name Middle Name/Initial
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Mailing Address -Street Number, Street Name, or P.O. Box
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City, State, Zip �� �l-?�,�� } /
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)
D County D Public Health Trust
Department
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Position or Title
(Municipality)
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Employee ID Num�er 1
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Work telephone -so�-z4o-,02
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 (0) 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
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I hereby swear (or affirm) that the information above is a true and correct statement. RECEIVED BY ELECTIONS DEPARTMENT:
D Hardcopy
�ctronic Copy
OFFICE USE ONLY Accepted: Y I N Deficiency: __________ Processed Date/Initials: ______ Scanned Date/Initials: _____ _
138_01 -22 COE 20 16
6044 SW 129 Ave miami,FL.33183
Received August 22, 2022
Office of the City Clerk