Daniel Gato 2023Docu&gn Envelope ID: A0243FA6-D8144D38-BF37-79FB69AC9BF4
MIAM 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.
Diselosure for Tax Year Ending Last Name Hirst Name Middle Name/initlal
JV i G ,"qTu �_) q i"rC
MaNhl«g Address - Street Number, street Name, or R0. Boat
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. 0
Fling as all SnobM (rock am)
[_ County Public Health Trust / Municipal
(Municipality)
- -
Daparhraerat
ze T -C
OMWon
I Fig, n..}
Position or Title
Employee 10 Number
Work telephone
Please list the sources of outside employment (including self-employment), the nature of the work, and the = amounts of money or other
compensation you received for each source of outside employment. If no income or compensation was received from a particuiar outside
employment, enter Mr (0) for that organization in the section below. It continued on a separate sheet, check here.
Name and Address
of the source of Outside income
Nature of the
Work Performed
Total Amount of Money or
Compensation R;ecefved
5 zlru
I hereby swear (or affirm) that the information above is a true and correct statement
Signature of
Date signed '
!'r M 1 -M I 1 01
REGEIVED BY ELECTIONS DEPARTMENT:
Hardcapy
Electronic Copy
)I^FICE USE ONLY Accepted: Y J N lViciency: Processed Date/Imb s: Scanned Date/lnitals:
3901-22 COF 2016