Rivera, Edwin
RECEiVED
CITY CLERK'S DEPT.
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OUTSIDE EMPLOYMENT STATEMmNt7 2005
For Full-time County and Municipal Emplo ees
Time
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 MIAM1-D CODE.
Filing as a (check one):
First?' /I t
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D "iami-Dade County Employ~
[!2J'Municipal Employee of: L c!( 01 /A, ~_.' Z ~ C4C: ~ .
Middle
Position Title: . OJ / ('
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County/~nicipal Department:
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If your home address is exempt from public records pursuant
to Florida Statutes ~ 119.07, please check here: D
Mailing Address (Street Name and Number)
,-r-
c.u I VO S2 I'Ll!....
CountylMunicipal Division:
Work Telephone:
7(, l r-
Apt. #
State
Fr
Zip Code.
'"3 ~ /7
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
Outside Income
Nature of the Work
, Performed
~ dolt M e/ Sette/Ie (.
Amount of Money or
Compensation Received
tJI /0 DO
. hr::JvL.
'. .,.
Af/rANt~ ./#..y;,hlf; (,(b>>fJ
~ fos f()o.J -S b .5 T
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if
information is a true and correct statement.
Signature of Person Di 10'
Date Signed
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10/261l1ll