Erica Latrice Ruffin I~- 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 ~/
1ST OF EACH YEAR IN ACCORDANCE WITH SECTION 2-11.1 K 2 OF Disclosure for ~ ~Qj
THE MIAMI-DARE COUNTY CODE. ()() Tax Year Ending:
Name: ~st C~1 Firsts Middle
Filing as a (check one): ~ Miami-Dade County Employee
Municipal Employee of: ~ .
Position Title:
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County/Municip Department: Count
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If your ho address is exempt from public records pursuant Work
to Florida Statutes § 119.07, please check here:
Mailing Address (Street Name and Number} -
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City State
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Apt. #
Zip Code
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Please Est 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
Outside Income Amount of Money or
Pertormed Compensation Received
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I hereby swear (or affirm) that the aforesaid information is a true and correct statemerrt.
Signature
Date Signed
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