Carol S. Graham~>
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OUTSIDE EMPLOYMENT STATEMENT
nnl~w For Full-time County and Munlclpal .Employees
FULL-TIME COUNTY AND MUNICIPAL EMPLOYEES ENGAGING IN .OUTSIDE ' y
EMPLOYMENT MUST FILE AN ANNUAL DISCLOSURE REPORT BY JULY
T O
YE Disclosure far
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F EACH
AR IN ACCfJRDANCE WITH SECTION 2-91.1(x)(2) OF TaX Year Ending:
THE MIAMI-DADE'COUNTY CODE..
Name: last ~ First Middle
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F'rGng as a {check one): ^ Miami-Dade County Employee
Munia I Em^'(Weeof:?,r~.~; ~~~ .
Position Title:
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County/Municipal Department: ~ County/Municipal Division:
!f your home address is exempt from public records pursuant Work Telephone: ,:
to Florida Statutes § 919x)7, please check.here: ^ 3~~- _ ~ ' „ '~ ~Q~1
Mailing Address (Street Name.and Number), Apt. #
City 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.- tf wntinued 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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swear (or affiim) that. the aforesaid. information is a true and conrnect statement.
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Signature of'Person Disclosing
. Oate Signed
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