Alfredo Perez Jr 2023MIAM~DADE - EI 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 Name First Name Middle Name/Initial
2023 5-- Atf»
Mailing Address - Street Number,
2 0 O Mo T N/e-
City, State, Zip
Ou tu) l
t 7 33/9
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 [] Public Health Trust (J mica» Cul_omni.z
(Municipality)
Department
Position or Title A. Work telephone
2- 151-03lf
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. []
Name and Address
of the Source of Outside Income
riv- ft)9-t
kg} wdh Nw a
Nature of the
Work Performed
Total Amount of Money or
Compensation Received
I hereby swear (or affirm) that the i ormation above is a true and correct statement. RECEIVED BY ELECTIONS DEPARTMENT:
D Hardcopy
[] Electronic Copy
OFFICE USE ONLY Accepted: Y / N Deficiency: Processed Date/Initials: Scanned Date/Initials: _
138_01-22 COE 2016