Peseny, Charles
OUTSI,DE 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:
THE MIAMI-DADE COUNTY CODE.
Name: Last
Middle
If
Filing as a (check one):
o Miami-Dade County Employee
~nicipal Employee of: C
Position Title:
~,.- d
If your home address is exempt from public
to Florida Statutes 9119.07, please check here:
Mailing Address (Street Name and. Number)
Apt. #
uant
City
State
Zip Code,
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: D .
Name and Address of the Source of
Oul$idelncorne
Opff(e Of- ~ ~.y
(9~ft(L ({() S e h ~-i
P; r-e ! J-D 0 f2-r
C<t,JdAr{;t pt . 0
Nature of the Work
Perfonned
Amount of Money or
Compensation Received
~1V(f
J-d/("&
) that the aforesaid ~mJ~rfis:atrue and'correct statement.
Signature of P
1l112M1O