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HomeMy WebLinkAbout6/27/2023 - Municipal Elected Official Outside Concurrent Employment Annual Disclosure Formf..11 I 1 • '� ILL CD r• . ti";} BROWARD COUNTY ELECTED OFFICIAL CODE OF ETHICS OUTSIDE/CONCURRENT EMPLOYMENT DISCLOSURE FORM MUNICIPAL ELECTED OFFICIALS /FOR Name of Elected Official: t wi 17 V ' I14 c rn1� Calendar year covered by disclosure form: Name of outside or concurrent Remuneration received Direct employer contributions to employer during covered year retirement Please state exact amount or check applicable box p l IZvrp- f�S� �� Vtc,;++,v TI-Under $1,000 ❑ $1,000 - $5,000 Did you receive any direct employer 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 ❑ $1,000 - $5,000 Did you receive any direct employer contribution to retirement from this 1 ❑ $5,001 - $10,000 employer during the reporting period? ❑ $10,001 - $25,000 ❑ Yes No ❑ $25,001 - $50,000 If yes, was his amount incuded in the [Z $50,001 - $100,000 exact remuneration amount or range ❑ Over $100,000 disclosed in the prior column? ❑ Exact Amount ❑ Yes [:]No ❑ Under $1,000 El $1,000 - $5,000 Did you receive any direct employer contribution to retirement from this El $,001 - $10,000 employer during the reporting period? ❑ $10,001 - $25,000 ❑Yes K No R$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: Z""" !�~ Date: If this form amends a previously filled form, please check this box ra 33 .a . vl•�4..: 4i �i BROWARD COUNTY ELECTED OFFICIAL CODE OF ETHICS OUTSIDEICONCURRENT EMPLOYMENT DISCLOSURE FORM \ rFOR MUNICIPAL ELECTED OFFICIALS Name of Elected Official: E \ J, n V \ \1 t-\l I V i Calendar year covered by disclosure form: ')L0 �.a- Name of outside or concurrent Remuneration received Direct employer contributions to employer during covered year retirement Please state exact amount or check applicable box Under $1,000 Did you receive any direct employer J ` `,' l/�' ❑ $1,000 - $5,000 contribution to retirement from this employer duringthe reporting period? � ❑ $5,001 - $10,000 $10,001 - $25,000 ❑Yes $No JS$25,001 - $50,000 If yes, wasilhis amount incuded in the El $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? �� ❑ $10,001 - $25,000 []Yes MNo ' J I ❑ $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 1� © $5,001 - $10,000 employer during the reporting period? (] $10,001 - $25,000 []Yes [RNo $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: '' `- -"� Date: / %-7 / )-e 3 If this form amends a previously filled form, please check this box