Orlando Del Sol 2009 MIAMFD OUTSIDE EMPLOYMENT STATEMENT
For Full-time County and Municipal Employees
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: .ODg•
THE MIAMI-DADE COUNTY CODE.
Name: Last First Middle
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Filing as a(check one): ❑ Miami-Dade County Employee
[unidpal Employee of (� B MII I &4di .
Position Title:
•
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County/Munici I Deppartm County/Municipal Division:
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!f you home address is exempt from public records pursuant Work Telepho : G/
to Florida Statutes§ 119.07, please check here:❑ 305: 4,-73701 4 z(47 z
Mailing Address (Street Name and Number) Apt.#
City State Zip Code
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 here: ❑
Name and Address of the Source of Nature of the Work Amount of lifloney'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. .
Sig _ 4A/
.11 i /• ...cling Date Signed
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