Donald M. Papy IAMtD~ 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 .IULY
1ST OF EACH YEAR IN ACCORDANCE WITH SECTION 2-11.1(K)(2) OF Disclosure for
Tax Year Ending: ~ d~~
THE MIAMI-DADE COUNTY CODE.
Name: Last
~U~'y First
~y~~~~ Middle
~
Filing as a (check one): ^ Miami-Dade County Employee
11
Municipal Employee of: C%°Y O'~ ~~°'~"~ % ~~~,
Position Title: / / >
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County/AAunicipal Department: County/AAunicipal Division:
/f your home address is exempt from public records pursuant Work Telephone:
to Florida Statutes § 119.07, please check heree: ^ 3 O ~: ~ 73. 7 S~7c~
Mailing Address (Street Name and Number} Apt. #
5~s1 S~v 8~ St-
C~y /~,, 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 sheet" please check here: ^
Name and Address of the Source of Nature of the Work Amount of Money or
Outside Income Pertorrned Compensation Received
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I hereby swear (or affirm) that the aforesaid information is a true and correct statement. ~`'
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Signa of Person Disclos}'~ Date Signed
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