Lori Ellen Freedline OUTSIDE EMPLOYMENT STATEMENT
� I M I A AA FDADE
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:
THE 11A w-DADE COUNTY CODE.
Name: Last First Middle olzi
Filing as a(check one): ❑ Miami-Dade County Employee
Umunicipal Employee of: Aft,
Position Title:
County/Municipal Department: County/Municipal Division:
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!f your home address is exempt from public records pursuant Work Telephone:
to Florida Statutes§ 919.07, please check here:
Mailing Address (Street Name and Number) Apt.#
Cj (ohs 3//
city State zip Code
e" 73l Yo
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
All
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I hereby swear(or affirm)that the aforesaid information is a true and correct statement.
Signatur of Person Disclosing "P y{ 33 11 Date Signed oz