Kathie Gene Brooks ~ r-- .•,
MIAMFDADE
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OUi'SIDE EMPLOYMENT STA IUIENT
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For Fuli-time County and Municipal Em
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FULL-TIME COUNTY AND MUNICIPAL EMPLOYEES ENGAGING IN OUTSIDE C' ~ `~ ~ ~- ~ ? ~'~ 'j J F ~- ~ r, ~.
EMPLOYMENT MUST FILE AN ANNUAL DISCLOSURE REPORT BY .JULY
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2 Disclosure for
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(K)(
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1ST OF EACH YEAR iN ACCORDANCE WITH SECTION Tax Year Ending:
THE MIAMI-DADS COUNTY CODE.
Name: Last First Middle
$~ooK.S KITH 1 L GE ~ G-
Filing as a (check one): ^ Miami-Dade County Employee
Municipal Employee of: M I A 1-1 1 $ EA G i-1
Position Title:
~~ 2 E e/T o~. 3V.D G-E~ ~ Q ~e F aQ. M P~w- C£ , M P e ov'~{ E ~ ~
County/Municipal Department: County/Municipal Division:
If your home address is exempt from public records pursuant Work Telephone:
to Florida Statutes § 419.07, please check here: ^ 3 ~ S - ~ R 3 - ~ D I ~
Mailing Address (Street Name and Number) Apt. #
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639 LA C;v2. G~ .D2~JE -=
City State ;Zip
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M1~M1 8G-AGN ~~- 3~t?
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Please list the sources of outside employment, the nature of the work and the amounts of monpyor at~er
compensation you received. tf contirwed on a separate sheet, please check here: ^ ~ ~
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Name and Address of the Source of Nature of the Work Amount of Mcgney~ctr
Outside Income PerFormed CompensatiorrRec~ied
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1 hereby swear (or affirm) that the aforesaid information is a true and correct statement.
Signature of Person Disc ing Date Signed
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