Narinder Singh 2012 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(x)(2) OF Tax Year Ending:
THE MIAMI-DADE COUNTY CODE.
Name: Last First Middle
Filing as a(check one): ❑Miami-Dade County Employee
PI-Municipal Employee of: CjTY
Position Title:
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County/Municipal Department: County/Municipal Division:
ff your home address is exempt from public records pursu�w Work Telephone:
to Florida Statutes§ If 9.07, please check here: 01�90
Mailing Address (Street Name and plumber) Apt.#
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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. tf 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 cornett statement.
Signature of Person Disclosing Date Signed
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