Arnaldo Bugallo~~ 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(x)(2} OF
THE MIAM
D Disclosure for
Tax Year Ending:
I-
ADE COUNTY CODE.
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Filing as a (ch k one): ~ iami-Dade County Employee
Municipal Employee of: ~ ~,
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Positio itle: ~ ~
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Co ty/Municipal De nt: County/Municipal Division: U; Z,
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If }rour home ad ss is a pf from public records p rsuant Work Telephone: Gy
to Florida Statutes 119.07, ~' -
§ please check here:
Mailing Address (Street Name and Number)
Apt. #
City
State Zip Code
Please list the sources of outside employment, the nature of the work and the amounts of money or other
compensation you received. ff 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
Performed Compensation Received
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I hereby swe (or affirm) that the aforesaid information is a true and correct statement.
Sign ure arson Di losing Date Si ned
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