Viviana Alemany 11/9/2009 IAMFDADE
~ OUTSIDE EMPLOYMENT STATEMENT
~ For Full-time Coun and Munici al Em ~lo ees
tY P P Y
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(x)(2) OF DisciOSUre fof ~~
Tax Year Ending:
THE MiAMhDU1DE COUNTY CODE.
Name:
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G~///1'~- Middle
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FiNng as a (check one): ^ Miami-Dade County Empkyyee
Munidpal Employee of: ~~ '~ ~~~ ~~~=Of~~
Position Title: C ~Ql~/~`J~ ~1'orli7s~~i"
County/Munlcipal Department:
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if your home oddness is exempt from public records pursuant Work Telephone:
to Florida Statutes § 119.07, please check here: ^ ~ ~ ~~a _ 7pD0 ~( .• ~~'f~
Mailing Address (Stnset Name and Number) Apt. #
'3~j/ ~GCJ /4'~Z r~JitlJC
City State Zip Code
~ld~t/ ~L 33iN"
Please list the sources of outside employment, the nature of the work and the amourres of money or other.
compensation you received. !f oarrtinued on a separate sheet, please check here: ^
Name and Address of the Source of Nature of the Work Amount of Money or
Outside Income Perlbrmed Compensation Received
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1 hereby swear (or affirm) that the afon~aid infomration is a true and oomect statement.
Signature of Person Disclosing Date 'gned
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