Judy Hoanshelt 2009r^5 ~" n r-•
1
OUTSIDE EMPLOYMENT STATEMENT
~ 2~ S8 For Full-time County and Municipal Employees
LL-71~A~ C50UAtT~'1ARGa (~~INICIPAL EMPLOYEES ENGAGING IN OUTSIDE
EMPLOYMENT MUST FILE AN ANNUAL DISCLOSURE REPORT 8Y JULY
1ST OF EACH YEAR IN ACCORDANCE WITH SECTION 2-11.1(K)(2) OF Disclosure for c~
Tax Year Ending: ~ 1
THE MU4MhDADE COUNTY CODE.
Name: Last First Middle
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Filing as a (check one): ^ Miami-Dade County Employee
~Muniapai Employee of: CI Z 4 dF rn 1 IP~i'y~ ~ .13 t/4f ~~
Position Title:
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County/Municipal Department: County/Municipai tJivision:
It your home address is exempt from public records pursuant Work Telephone:
to Florida Statutes § 119.07, please check here: ^ C ,~~ ~~ 3 ~ C~~j ~~ ~3
Mailing Address (Street Name and Number) Apt. #
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City State Zip Code
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Please list the sources of outside employment, the nature of the vuork and the amounts of money or other
compensation you received, tf 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
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I hereby swear (or affirm) that the aforesaid information is a true and correct statement.
Signature o Person Disclosing Date Signed
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