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Warren William Green
~, . ~- ~ ; r ,~, - -;; . °M~I'AM~FDADE OUTSIDE EMPLOYMENT STATEMENT.:.. ~' ~' ` ~ ~ ~ {: - For Full-time County and Municipal Employees `t~. , ,~; ~. __ • FULL=TIME COUNTY AND MUNICIPALEMPLOYEES ENGAGING IN OUTSIDE ~~~ ~~ EMPLOYMENT :MUST FILE "AN ANNUAL DISCLOSURE REPORT BY JULY ~ ~ ~ F Disclosure for ~' a . 1ST-OF EACH YEAR IN ACCORDANCE WITH SECTION 2-11.1(K)(2) OF TaX Year Endin •~©/G~ ' THE MIAMI=DADE COUNTY CODE. g" Name: Last. ~ ~ First Middle . . Filing;as a (check one): ~. Miami-Dade County .Employee Municipal Employee of: _~~"/d~j~~~7j ~,.¢~~ ~. - Position Title: 'County/Municipal Depart/m~ent: County/Municipal Division: ' . If your home address is exempf from public records pursuant Work Telephone: to Florida Statutes-§ 1)9.OZ; please check here: Mailing Address (Street Name and Number) Apt. # - . . City State ~ Zip Code /~/. /~~~G~~~D~ ~~~~ . .Please list the sources of outside employment, the nature.of the work and the amounts of money or other compensation you received. • !f 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 .: ~ ' !/d7//7"~D ~~. ~~~~5~~/~iE'1' y" C~.ol/~f/,j ,~~jj ~~.~, ``'a.~/2 ~~>f/r, .. _ _ ~' .. • i hereby swear (o i t lfe aforesaid information is a.true and con-ectstatement. Signatur I n Date Signed -~2- ~/® ~' ,az~o :. - ~.,. . v • ,r