Andrea L. Amy MIAMwAD>= OUTSIDE EMPLOYMENT STATEMENT
M 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(x)(2) OF Tax Year Ending: 020
THE MIAMI-DADS COUNTY CODE.
Name: Last First Middle
L
Filing as a(cLk one): ❑ Miami-Dade County Employee
ffmunicipal Employee of or
Position Title:
Criw_ &WL"10chnior,11)
County/Municipal Department: County/Municipal Division:
10, W 1 6Q 1 poha_ I Tnvq)� o'ns
if your home address is exempt from pudic records pursuant Work Telephone:
to Florida Statutes§ 119.07, please check heree:❑ 30G- �4 >Zx q
Mailing Address (Street Name and Number) Apt.#
gao a
City State Zip Code
w �ian c S F, 3333
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: F]
Name and Address of the Source of Nature of the Work Amount of Money or
Outside Income Performed Compensation Received
V�. ,5 p1cm 'SU I-j-e -�Crec�clSur� 1/C1�i 1CU
3 -Le 4
Own'IX Ari-&M
I hereby swear(or affirm)that the aforesaid information is a true and correct statement.
Sig a of Person Disc -ng Date Signed
�I Z
,=8100