Rodriguez, MarleneMI
~ 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
1ST OF EACH YEAR IN ACCORDANCE WITH SECTION 2-11.1(K)(2) OF Disclosure for a ~~
Tax Year Ending' ~l(/
THE MIAMI-DARE COUNTY CODE.
Name: Last
Ta l o/ First
ma~ie~e Middle
~Vri;clVle
Filing as a (check one): ^ Miami-Dade County Employee
M Q~ ,,,(,,
Municipal Employee of: ~~ ~ t' / ~a~ r l~-c.1C.Y
Position Title:
Obi ce ~~soC~t Cie ~
County/Municipal Department:
ma COY ancQ Comm'~~s1~t~ ~F-Fic~ County/Municipal Division:
/f your home addmss is exempt from public records pursuant Work Telephone:
to Flonda Statutes § 119.07, please check hem: ^ 3~ - ~`7 3 - ~ (d3
Mailing Address (Street Name and Number) Apt. #
~S 30 `~cc~ IDS Coc,c r~--
C'~' ~ ~ State ~~
IQm j Zip Code
~31~3
Please list the sources of outside employment, the nature of the work and the amounts of money or other
compensation you t+eceived. If continued on a separate sheet, please check hem: ^
Name and Address of the Source of
Outside Income Nature of the Work
Performed Amount of Money or
Compensation Received
~'!or'tdc~ sr+t~-/r>~~ion~ I -rich ar') ~Z~.u (ccru.~~s -
(~n fivers t - ~f-e c~-F
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or ccx,crs
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I hereby swear (or affirm) that the &foresaid information is a true and correct statement.
Signature of Pe~ ~ng Da
e S'
ed
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