Perez, Luis R. 6/20/06
"DADEt 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 1'2.1 a I /zoos
1 ST OF EACH YEAR IN ACCORDANCE WITH SECTION 2-11.1 (K)(2) OF Tax Year Ending:
THE MIAMI-DADE COUNTY CODE.
Name: Last ~~E. z.. First Lu \ S Middle
'R.
Filing as a (check one): o Miami-Dade County Employee
~Municipal Employee of: Cl"T'\ Of Ml,6.tot, -e,e-ACA
Position Title:
C H\c.'f &~ UC{\I ~AL. f'~5 exAM I foJ e. fC:
County/Municipal Department: County/Municipal Division:
eu, LD'.J E1 S~Uc.rureA'-
If your home address is exempt from public records pursuant Work Telephone:
to Florida Statutes & 119.07, please check here: ~ (~S) "1 ~ - i boo C'7~O )
Mailing Address (Street Name and Number) Apt. #
I a,~ 44 s.w. l!::o 1Ji Cou -=T
City 'PA\...r\E;"'1""D '86.\ State Zip Code
VI t,..C..A. c;..e of FL 3?>IS,
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 a separate sheet, please check here: 0
Name and Address of the Source of Nature of the Work Amount of Money or
Outside Income Performed Compensation Received
tIJoc..f~G. ~VAI<6Z.; ~",'S C.O '"" ~u L..TlI'-l C. oA.l ~ SOO~
l~o~ ~ Ret10 Ave. .
~)\% aoCl r'tLo'1E"f$ ~ w"'" \c&.,
Co~ G.... 0l..E.s./ 1= L- 3~ 14C. ~~ €ow c:,u.,)~ csf
~ E: cotC.O
I hereby swear (or affirm) that the aforesaid information is a true and correct statement.
.-
Signature of Person Disclosing 4t- Date Signed
e:,/~OJoc.
/
10/26100