Nichole Dotey 2022MIAMI·
EDI
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(k)(2) of the Miami-Dade County Code.
Disclosure for Tax Year Ending Last Nam
2022 \0
Middle Name/initial.,
le (
City, State, Zip
1O fL
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 [] Public Health Trust []Municipal
(Municipality)
Employee ID Number \ai@u \,a
Work telephone
5as 73 79o
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
of the Source of Outside Income
Nature of the
Work Performed
I hereby swear (or affirm) that the information above is a true and correct statement.
siu»airer.o osceoso
RECEIVED BY ELECTIONS DEPARTMENT:
D Hardcopy
[ Electronic Copy
RECEIVED
JUN 14 2023
O F MIAMI BEACH CIT "e or CLERK OFFICE CF THE o
OFFICE USE ONLY Accepted: Y / N Deficiency. Processed Date/Initials: Scanned Date/initials:
138_01-22 COE 2016