Allison R. Williams MIAMFDADE OUTSIDE SIDE EMPLOYMENT .STA 1 EMENT
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 MIAMI-DARE COUNTY CODE.
Name: Last First Middle
al
Filing as a(check one): ❑ Miami-Dade County Employee
Q Municipal Employee of: III A4444 C1
Position Title:
CQ
CountylMunicipal rtm&"Ct ent: County/Municipal Division: l
4j Leu
If your home address is exempt from pub/A.records pursuant Work Telephone.
to Florida Statutes§ 919.07, please check here:❑ joS • b43- -10' X (A a
Mailing Address (Street Name and Number) Apt.#
1100 fiM, �wt/ 3d �r
City State Zip Code
i a)ww .33 l3
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
' �h &� VAIHIOZ by C ad �-�=�da �► � �� �
I hereby swear(or affirm)that the aforesaid information is a true and correct statement.
Signature of Person Disclosing Date Signed
a� 20