HomeMy WebLinkAbout6/21/2021 - Municipal Elected Official Outside Concurrent Employment Annual Disclosure FormBROWARD COUNTY ELECTED OFFICIAL CODE OF ETHICS OUTSIDE/CONCURRENT EMPLOYMENT
DISCLOSURE FORM FOR MUNICIPAL ELECTED OFFICIALS
Name of Elected Official: Michelle J. Gomez
Calendar year covered by disclosure form:
2 020
Name of outside or concurrent
Remuneration received
Direct employer contributions to
employer
during covered year
retirement
Please state exact amount or check applicable box
Saunders, Curtis, Ginestra & Gore, P.A.
❑ Under $1,000
Did you receive any direct employer
$1,000 - $5,000
contribution to retirement from this
❑ $5,001 - $10,000
employer during the reporting period?
0 $10,001 - $25,000
❑Yes 0 No
❑ $25,001 - $50,000
If yes, was this amount incuded in the
❑ $50,001 - $100,000
exact remuneration amount or range
❑ Over $100,000
disclosed in the prior column?
Exact Amount
❑Yes 0 No
=
❑ Under $1,000
Did you receive any direct employer
❑ $1,000 - $5,000
contribution to retirement from this
❑ $5,001 - $10,000
employer during the reporting period?
"
❑ $10,001 - $25,000
[]Yes ❑ No
❑ $25,001 - $50,000
If yes, was this amount incuded in the
❑ $50,001 - $100,000
exact remuneration amount or range
❑Over $100,000
disclosed in the prior column?
❑ Exact Amount
❑Yes ❑ No
❑ Under $1,000
Did you receive any direct employer
❑ $1,000 - $5,000
contribution to retirement from this
❑ $5,001 - $10,000
employer during the reporting period?
El $10,001 -$25,000
❑Yes ❑ No
❑ $25,001 - $50,000
If yes, was this amount incuded in the
❑ $50,001 - $100,000
exact remuneration amount or range
❑ Over $100,000
disclosed in the prior column?
❑ Exact Amount
❑Yes ❑ No
Signature of Elected Official: �Ta
If this form amends a previously filled form, please check this box ❑
Date: June 17, 2021