Perez, Luis R.
. .
CITY OF MIAMI BEACH
REQUEST FOR APPROVAL OF OUTSIDE EMPLOYMENT
Page 1 of 2
I. 0 BE COMPLETED \BY EMPLOYEE - This Form must be completed & ;IPI>roved prior to
beginning any other employment
A. INF RMATION REGARDING CITY OF MIAMI BEACH CMS EMPLOYMENT
10 # DEPARTMENT ( DIVISION
EMPLOYEE ME: LAST NAME, FIRST NAME, MIOCiLE NAME
'Pe-r2 ~ Lu ("=> 1<
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Me.. Co).,lACM-J6,
WORK~HONE # '
(1oUGo,3-
1<>00 C4>1~)
r:!"ORK PHONE #
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1000 (G. &DG:> )
HOME PHONE #
( 1;>oS') Gf II .. 86 t;; '1
JOB TITLE
C-H-\6f ~'(I'Wq\.>t<,.A.l.- ~ e)~"r1lt.ld
DAYS AND TIMES
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I
EMPLOYEE'S OTHER PHONE #s (BEEPER. c:i i If
(1 CO~) 41'"2,. 3G. )~)
To BE COMPLETED By SUPERVISOR: D~;i j ~~ THE
INFORMATION IN THIS SECTION? _" (Ell __ No
1\
INFO MAllON REGARDING OUrSIDE EMPL.OYMENT
EMPLOYEE 10 #
DEPARTMENT I DIVISION
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WORK P,"ONE #
TYPE OF BUSINESS "
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JOB TITLE
WORK PHONE #
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1~lb
DATE OF HIRE
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e: ~U5 3. t?Ae~l..-
DAYS AND TIMES
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CITY '(:::\:)'~Jo.rL.
STATE f-L- ZIP ~~l1 ~
DESCRIPTION 0 DuTIES
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\iVHAT DUTIES GHT BE CONSIDERED TO BE A CONFl.IGT OF INTEREST
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This form h;as 2 pages - be sure to complete both pages