Kimberly Anne McCoyM~~~ OUTSIDE EMPLOYMENT STATENlENT~ C; ,~= t •~ ~ ~
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 DiBClosure for ~~ ~ ~- r, f °, ,°~
1ST OF EACH YEAR IN ACCOROIAwCE WITH SECTION 2-11.1(K)(2) OF Tax Year Ending' 0 ~ f ~ ~V ~-
THE MIAMhDADE COUNTY CODE.
Name: Last
Filing as a (check one):
Position Title:
~~ C6V' ~ ~Sfi .
County/Municipal Defx
First
^ iamaDade County En
Municipal Employee of:
If your home address rs a mpt from public records pursuanf
to Florida Statutes § 119.07, please check here: ^
Mailing Address (Street Name and Number) 4
Mid
L
County/Municipal Division:
Work Telephone:
~ 3~~ .~ ~ ~3 ~~1~6 ~~
_ Apt. #
State Zip Code
~ 3~ /~I
Please list the sources of outside employment, the nature of the Work and the amounts of money w other
compensation you received, if continued on a separate sheet; please check here: ^
Name and Address of the Source of
Outside Income
~(IVtG~~ ~n~~~ ~d'~
V~ rv~i-rs'~ Co~GG~~ o~
l~
Nature of the Work
Performed
~~~~
Amount of Money or
~mpensation Received
1 ~ VV
~ D r d~
thereby swear (or affirm) that the aforesaid information is a true and correct statement.
~a /3V