Donald Mark Papy MIAMFDADE 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: �� I J
THE MIAMI-DADS COUNTY CODE.
Name: Last FimU>7 Middle
Filing as a(check one): ❑ Miami-Dade County Employee
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wN Municipal Employee of: �/ --�
Position Title:
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County/Municipal Department: County/Municipal Division: v� T" 71<
1 CD
CO
If your home address is exempt from public records pursuant Work Telephone:
to Florida Statutes§ 119.07, please check here:❑ '3c5-, b-73.7"170
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 Money 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.
Signature of Person Disclosing Date Signed