Vivian Alemany _
Mlan~ OUTSIDE EMPLOYMENT STATEMEN
For Ful(--time County and Municipal Employees
FuLL 1~ Cot~'rY ataD w~ac~at Ems ENC~NG w ovrsioE D ~ ~O~
EIAPLOYMENT k1UST FILE AN MNUAL DISCLOSURE REPORT BY .IUI.Y
1y.-r ~ ~ inEaR w a wtTM SECTION 2-11.1(Kx2) of T~ Year Ending:
TtE MwuIhDADE COIAr1Y CODE.
Name: last First Mldcfie
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Filing as a (deck one): ^ Miami-Dade t,.ounty Employee
~Mu~ppai Elrlpioyee of• ~/ .~,~g'~,~sr~.~
Position Tithe: C~~i~~'D~/Q°~' ~'~~~ '~
Cour>ty/Munidpal Department:
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CouMy/Mtpm~ Division:
ff your home address is exempt ham pub!rc r+eoords pursuar+t 1Nork Telepllor~e:
to Florida Statutes § ? 19.07, please check hem: ^ ~~~ X73 - 70~ X - 2~lGe.
Mailing Address (Street Name and Number] Apo. ~
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aty State _ T-~p code
Pleaee list the sources of outside employment, the nature of the work and the amourrts of money a dher
lion you received. ncca~trnued on a separate sheet please check here: ^
Name and Addnitss of the Source of Watup * ~°
Outside income t:
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{ het+e~t Swear (Or affirm) that the aforesard 11S a OOrT+eGt StatEYnent. ~, ~
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Signature of Person Qisdosin9 Date .
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