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HomeMy WebLinkAbout6/16/2021 - 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: Elberg Mike Gelin 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 Gelin Benefits Group © 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 E]Yes ®No © $25,001 - $50,000 If yes, was this amount incuded in the © $50,001 - $100,000 exact remuneration amount or range 0 Over $100,000 disclosed in the prior column? ® Exact Amount ElYes © No 0 Under $1,000 Did you receive any direct employer [:1$1,000 - $5,000 contribution to retirement from this ® $5,001 - $10,000 employer during the reporting period? © $10,001 - $25,000 r]Yes © No 0 $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? rl 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? ® $10,001 - $25,000 ElYes D 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? 94 Exact Amount ®Yes ® No Signature of Elected Official: Date: 06/16/2021 If this form amends a previously filled form, please check this box