Richard McConachie~„AM~,,o~ Ol1TSIDE EMPLOYMENT STATEMENT
~ For Full-time County and Municipal Employees
1=uil-time County and muniapal employees engaging in outside
employmern must file an annual disclosure report by July 1st of y ,,,,
Disclosure for G °
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each year, in accordance with Section 2-11.1(k)(2) of the Miami-
Dade County Code. Tax Year Ending:
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Last Name: ~ c~,
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First Name: i C~~~~/~ Middle Name: .,~.
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Employee ID #: I I
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Filing as (check one) ^ Miami-Dade Co. Employeen,~ ~ ~ 2 ,, ` , ~~
Municipal Employee of:
Position Title: ~ ~ '~ ~ ~ (' /~ ~ ~~ ~ ~
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County/Municipal Departmern:
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~ CourrtylMunlicipal Division: ~ ~
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If your home adds s is exempt from public records Work Telephone:
pursuant to Florida Statutes § 119.07, please see the ~
note on the following page and check here: ~ ~~~ ~~~ v ~ ~~~
Mailing A1d[~dr~(/er~fs~s (Street Name and Number) ~~J\\J\ Apt. #
1 V 0 C~w~vt,-hY e~Y~ C •_ ,tee...
City ~\ ~ State Zip Code
~~ ~~ ~-Q~ ~ ~ 3 3 13 q
Please list the sources of outside employment, the nature of the work, and the amounts of money or other
compensation you received_ ff continued on a separate sheet, please check here: ^
Name and Address of the Source of
Outside Income Nature of the Work
Performed Amount of Money or
Compensation Received
~~, y~ a S w ~ ~~e ~~ a~,r ~~~~ 0
1 hereby swear (or affirm) that the aforesaid information is a true and correct statement.
Signat of Per n Disclosing
~~ Date Signed
(a~3~fo~lb
COE, 2008