Antwan Lamer Terry
~ OUTSIDE EMPLOYMENT STATEMENT
~ For Full-time County and Municipal Employees
FULL-TIAAE COUNTY AND MUNICIPAL EMPLOYEES ENGAGING IN QUTSIDE
EMPLOYMENT MUST FILE AN ANNUAL DISCLOSURE REPORT BY .JULY DisClOSUre fOr
~
1ST OF EACH YEAR IN ACCORDANCE WITH SECTION 2-11.1(I~(2) OF Tax Ysar Ending: ~ ~
~
THE MIAMI-DADS COUNTY CODE.
Name: last First Middle
Filing as a (check one): ^ Miami-Dade County Employee
^ Municlpal Employee of: C ; ~. ~ c~ ~ M ; 4 •~.~ ; (~ e A e 1~
Position Title:
rL e; v ~- ~+ m e. ~
County/Municipal Department: County/Municipai Division:
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If your home address is exempt from public records pursuant Work Telephone:
ro Florida Statutes § 119.07, please check here: ^
Mailing Address (StrBet Name and Number) Apt. #
1 40 W I ~Ic
City State
Zip Code
F ~a 33os
Please list the sources of outside employment, the nature of the v+prlc and the amourrts of money or other
compensation you n3ceived. li continued on a separate sheet, please check here: ^
Name and Addn~ss of the Source of Nature of the Work Amount of Money or
Outside Income Perfornled Compensation Received
Dade coort~,-y P~b1:cs~-.,~o~ ~'rl~ertgN~20~gc-o•,N~S g~S~.41 blweekl.~
A Ncl d ~ ; Id~N~
I hereby sw~lr (or affirm) that the afon~aid information is a true and correct statement.
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Signature of Person Disclosing Date Signed
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