Christopher MereinDocusign Envelope ID:CC1B7814-81CB-47C0-8168-2983CE0B5545
MIAMI-DADE.EIm 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()(2)of the Miami-Dade County Code.
Disclosure for Tax Year Ending
l
last Name First Name Middle Name/Initial
202 2024 0.,(Ch.sol«Lv is
Malling Address -Street Number,Street Name,or P.O.Box 1
€364 S6 I+7 Tee
City,State,Zipo+/a»r::L 353157
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.DJ
Filing as an Employee (check one)
[]county D Public Health Trust [XMunicipal pan i,P,)·.:=,,-t_Do Mon(Municipality)
Departmenl Division
fhm eel r De aa+on+r«6Qesue
Position or Title Employee ID Number
\
Work telephoneieuken-+63 (66)33-7v
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
[ho Dode lee]Mc'Ah ms /dyad Pal-ly I 54/1330 \»97fvoavKL333¥Enos tao,e L 1asle+0/elleote
I hereby swear (or affirm)that the information above is a true and correct statement.
Date signed
RECEIVED BY ELECTIONS DEPARTMENT:
[]Hardcopy
)eon%PEIVED
$EP 20 2024
CITY OF MIAMI BEACHOFFICEOFTHECITYCLERK
OFFICE USE ONLY Accepted:Y I N Deficiency.Processed Date/Initials:Scanned Date/Initials:138 01-22 COE 2016