Brooks, Kathie Gene "~ ' ,~ -z
MIAMFD
~~ OUTSIDE EMPLOYMENT STA ~pT P~ 12~ 2S
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For Full-time
FULL-TIME COUNTY AND MUNICIPAL EMPLOYEES ENGAGING IN OUTSIDE ~' I `~ ~" ~" ~''~~~ ~~ +~ ~~ ~rn ~ ~ ~'
EMPLOYMENT MUST FILE AN ANNUAL DISCLOSURE REPORT BY JULY
1ST OF EACH YEAR tN ACCORO~ANCE WJTH SECTION 2-11.1(K)(2) OF Disclosure for
Tax Year Ending: a00 7
THE MwMhDADE COUNTY CODE.
Name: Last First Middle
Filing as a (check one): ^ Miami-Davie County Employee
Municipal Employee of: M I A C`tl .g G-A Gt-t
Position Title:
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,
CountylMunicipal Department: County/Municipal Division:
SVDCTr/T $r P~2'FOt/MPrgGE 1~(P .
If your home address is exempt from public records pursuant Work Telephone:
to Florida Statutes § ? ? 9.07, please check here: ^ 3 o S - ~ ~ 3 - ~ O 1 O
Mailing Address (Street Name and Number) Apt. #
~03°~ t_A ~ o e. C~ tJ~.~~ G
City State Zip Code
I~(t A--t1 ~ERLH ~~, 33 too
Please list the sources of outside employment, the nature of the work and the amounts of money or other
compensation you received. If continued on a separate sheet, please check here: ^
Name and Address of the Source of Nature of the Work Amount of Money or
Outside Income Performed Compensation Received
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Y~SI O -,1S ~2.oV P MI'hlypt (~,~--t~+JT .
I hereby swear (or affirm) that the aforesaid information is a true and correct statement.
Signature of Person Disclosing Date Signed
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