Jeffrey A. Singer OUTSIDE EMPLOYMENT STATEMENT
MIAMw
~~ For Full-time County and Municipal Employees
Full nME CouNTY AND san~uclPAl. EM~oYEES ENC,A~ING nr OursIDE
EMPLOYMEM MiJST Fp.E AN ANNUM ttsPOR'r ErY JIAY Disclosure for ~ D J J
1ST of EACH YEAR ~ vY~iH SECTwN 2-11.1(ICx2) ~ Tax Yeah Ending:
THE MIAMI-DWDE COUNTY CODE.
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Filing as a (check one): ^ Miami-Dade Courtly E
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County/Munidpal Department:
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!f yrwr home address is exempt fro-n puWrc Wor1c Teleptrone: -7
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to Florida Statutes § 119.07, please dteclc he
Mailing Addt~ess (Sliest Name and Nu ~ Apt. ~
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Clty ~-eCJ~-~ ~ ~ State ? ~ 7"~ Tip Code
Please list the souroes of outside employment, the rlatlrre of the work and the amounts of money or other
lease check here: ^
arate sheet
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Name and Address of the Source of Nature of the Work Amount of Money or
Outside Income P
erfomaed Comper~ation Received
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1 hereby swear (or affirm) that the irrfomlatiar is a true and corretx statement. ~~ ~
Signature of Person Disclosing ~ ~
~ Date Signed
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