Aifa Alvarez .-.
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MIAM FD _
~`~~`' :OUTSIDE EMPLOYMENT Sl~~t~~1VNT~q,~; ~
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For'Full-time Coun and Munici a1' mr~lo ees
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~-FULL~tNIE COl1NTY AMID MUNICIPAL EMPLCOYEES ENGAGING IN OUTSIDE -
EMPL~~ENTJ MUST FILE AN ANNUAL DISCLOSURE REPORT BY' JULY
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Disclosure for =~ U ~ I
F E
H YEAR IN ACCORDA
CE WITH SECTION 2-11.1(K)(2) OF
f~ M~MI-DADS GouIVTYCODE. Tax Year Ending:
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Name: Last First ~ Middle . ,
Filing as a (check. one): ~ ^ Miami-Dade County Employee
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. ~ ~. Muniapal Employee of: D tlv` (~r~ ~~-Cy~
Position Title: I
County/Municipal rtment:
f. County/Muricipal Division:
!f your home .address is exempt from public records pursuant Work Telephone:
to 'Florida Statutes § 119. t7T, please check fiere: 0 3 b s~ ~3 3~ ~ G ~' 8 ~ 3
Mailing Address (Street Name and Number) ; ~ Apt. # ~.
Ciry 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. if continued on a separate sheet, please check here:
' Name,and Address- of the Source of Nature of the Work Amount:of Money or
" k. Outside income Performed 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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Signature of Person Disclosing ~ ~ - ~
. .Date Signed. ~ ""
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