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Charles W. Fossler
M ~ OUTSIDE EMPLOYMENT STATEMENT ~ - For Full time County and Munlclpal Employees FULL-TIME COUNTY AND MUNICIPAL EMPLOYEES ENGAGING IN OUTSIDE EMPLOYMENT MUST FILE AN ANNUAL DISCLOSURE REPORT BY JULY 1ST OF EACH YEAR IN ACCORO/WCE WITH SECTION 2-11.1(K)(2) OF DISCIOSUre ifor Tax Year Ending: 2©l0 TIE MWAAhDADE COUNTY CODE. Name: Last First Middle o~~~,z c~~-~~,~ S ~v Filing as a (check one): ^ Miami-Dade County Employ e e / ~ 1 ,/,/ Q ® Municipal Employee of: _L_ t T j ©/C/~6i~•L1/ yo~i~Cjy Position Title: County/Municipal Department: County/Municipal Division: C.=/~ If your home addross is exempt from public necads pursuant Work Telephone: to Florida Statures § 919.07, please check bane: ^ 3oS ~ 73. ~a Fx~. ~ y3~ Mailing Address (Street Name and Number) Apt. # iz~.o sue? ~~~ 7-~,e City State Zip Code /~<~~~ ~Lo,P~d>~4 ~3/7~ Please list the sources of outside employment, the nature of the work and tfie amounts of money or other compensation you received. tf continued on a separate sheet, please check here: ^ Name and Addn3ss of the Source of Nature of the Work Amount of Money or Outside Income Performed Compensation Received /~ho~ix ~.ca~iti~19 <9ssix~~ .s /,37L 7 S~ / S.~ "° S°T. '~ZD/ G'oX,fi/,~uC776,t, _ p - ~~g-ui, ~L 33/77 ~.c!'u/Ti't~ I hereby swealr (or affirm) that the aforesaid information is a true and oornect statement. Si arson D' Date Signed ~ -T~OIO