Tui J. Munday OUTSIDE EMPLOYMENT STATEMENT
MIAMw
~~ 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 ~~~ U
1ST OF EACH YEAR iN ACCORDANCE WITH SECTION 2-11.1(K)(2) OF Tax Year Ending:
THE MIAAAhDADE COUNTY CODE.
Name: Last First Middle
Filing as a (check one): ^ Miami-Dade County Employee
~Munidpal Employee of: ~`~`~ °`~ r^ ~ '~~"'` ~ ~ ~
Position Title:
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County/Munidpal Departmerrt: County/Munidpal Division:
tt your home address is exempt horn public records pursuant Work Telephone:
to Florida Statutes § 119.07, please check here: ^ 3 U ~ Gi ~ 3 ~ v0 0 ;{ b 3
Mailing Address (Street Name and Number) ~• #
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City 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. n continued on a separate street, please check here: ^
Name and Address of the Source of Nature of the Work
Perfom~ed Amount of Money or
Compensation Received
Outside Income
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I hereby sw~r (or affirm) that the aforesaid information is a true and correct statement.
Signature of Person Disclosing Date Signed
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