Orlando Del Sol IAMFD' OUTSIDE EMPLOYMENT STATEMENT
~ For Full-time County and Municipal Employees
FULL-TIME COUNTY AND MUNICIPAL EMPLOYEES ENGAGING IN OUTSIDE
EMPLOYMENT MUST FILE AN ANNUAL DISCLOSURE REPORT BY JULY Disclosure for
1ST OF EACH YEAR IN ACCORDANCE WITH SECTION 2-11.1(K)(2) OF Tax Year Ending: ~ -v
THE MIAMI-DADE COUNTY CODE. --t o
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Name: Last First Middle r_
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Filing as a (check one): ^ Miami-Dade County Employee ~ ~ ~,,~
Municipal Employee of: T~ ~? .~
Position Title: ~--, ~
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', County/Municipat Department: County/Municipal Division:
If y rho addnsss is exempt from public records pursuant Work Teleph e:
to Florida Statutes § 119.07, p/ease check here: ^ _ b.? ~7~3 r ~
Mailing Address (Street Name and Number) Apt. #
Cdy State Zip Code
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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 sheep please check here: ^
Name and Address of the Source of Nature of the Work Amount of Money or
Outside Income Pertormed Compensation Received
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I hereb (or a^) that aforesaid information is a true and correct statement.
Date
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