Laura C. Franco-Rubines MIAMwADE 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
THE MWMI-DADS COUNTY CODE.
Name: Last First Middle
EC l�
Filing as a(check one): ❑ Miami-Dade County Employee
Municipal Employee of: ot].(j
Position Title:
k I <
L
County/Municipal Departme County/Municipal Division:
�J_�� �if your home address is exempt from public records pursuant Work Telephone:
to Florida Statutes§ 119.07, please check here:❑ ,75 7 3— -70 Z O
Mailing Address (Street Name and Number) Apt.#
`y
00 Ccno.aw
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 Money or
Outside Income Performed Compensation Received
N
Ln -,
M
CD
I hereby swear(or affirm)that the aforesaid information is a true and correct statement.
Signature f Person Disclosing Date.Signed
10MM