Heather A. Ramos 2010 •
•
MIAMIDADE OUTSIDE EMPLOYMENT STATEMENT
For Full -time County and Municipal Employees
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FULL -TIME COUNTY AND MUNICIPAL EMPLOYEES ENGAGING IN OUTSIDE
EMPLOYMENT MUST FILE AN ANNUAL DISCLOSURE REPORT BY JULY Disclosure for
1ST OF EACH YEAR IN ACCORDANCE WITH SECTION 2 - 11.1(K)(2) OF Tax Year Ending: / C t 0
THE MIAMI -DADE COUNTY CODE.
Name: Last 0 r First Middle
Filing as a (check one): I 1 Miami -Dade County Employee
Municipal Employee of: Thi2 CA ilj of 1111 Fe'
Position Title:
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County/Municipal Department: County/Municipal Division:
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If your home address is exempt from public records pursuant Work Telephone:
to Florida Statutes § 119.07, please check here: ❑ 305 L9 -75 DL)
Mailing Address (Street Name and Number) Apt. #
L i ILI I NCvU4k1u5 Dr . Cpl 8i
City State Zip Code
t - 1; Ck I i ch F__ 33 I C
Please list the sources of outside employment, the nature of the work and the amounts of money or other
compensation you received. If continued on a separate sheet, please check hem: n
Name and Address of the Source of • Nature of the Work Amount of Money or
Outside income Performed Compensation Received
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(1116h-ti $rcick■ FL 3 3 i �
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` I hereby swear (or affirm) that the aforesaid information is a true and correct statement. - 1-s 4
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Signature of Person Disclosing Date Signed
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10,28,00