Rodriguez, Mario 05/06
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OUTSIDE EMPLOYMENT STATEMENT
For Full-time County and Municipal Employees
FULL-TIME COUNTY AND MUNICIPAL EMPlOYEES ENGAGING IN OUTSIDE
EMPLOYMENT MUST FILE AN ANNUAL DiSClOSURE REPORT BY JULY Disclosure for
1ST OF EACH YEAR IN ACCORDANCE WITH SECTION 2"'-11.1(K)(2) OF Tax Year Ending: . :;Ze;o b
THE MIAMI-DADe COUNTY CODE.
Name: last
First
o Miami-Dad~ County Employee
~ Municipal Employee of:
Filing as a (check one):
Position Title:
() eC-K Ht#td
CountylMunicipal Department:
CountylMunicipal Division:
If your home address is exempt from public records pursuant
to Florida Statutes S 119.07, please check here: 0
Mailing Address (Street Name and Number)
3'12 L s.',
YJ1o.n-f
Apt. #
City
State
Please list the sources of outside employment, the nature of the work and the amounts of money or other
compensation you received. If continued on 8. separate sheet, please check here: 0
Zip Code
S-
Name and Address of the Source of
Outside Income
Nature of the Work
Performed
Amount of Money or
Compensation Received
;:-1 S A~y :7'5 {a/vtd
De <. t I{ cutOr
~6 OIL HKS.
,. 00
I hereby swear (or affinn) that the aforesaid information is a true and correct statement.
Signature of Peroon Disci;;; _,_ .
-=-- YtL ~ ~
Date Signed
101261OO