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Narinder Singh 2014 • MIAMI-IaA®E OUTSIDE EMPLOYMENT STATEMENT COUNTY For Full-time County and Municipal Employees Full-time County(including Public Health Trust)and municipal employees engaging in outside employment must file an annual disclosure report by July 1st of each year,in accordance with Section 2-11.1(k)(2)of the Miami-Dade County Code. Disclosure for Tax Year Ending Last Name First Name Middle Name/Initial 2014 57/v6w A/a 4!&7/Q ''- Mailing Address—Street Number,Street Name,or P.O.Box /2'q r/r, City,State,Zip ID Number ir) M91 1 2_,. /2 9 If your home address is exempt from public records pursuant to Florida Statutes§119.07,please see note on the following page and check here.❑ Filing as an Employee(check one) 0 County/Public Health Trust unicipal K'//-7 �� /V7/11/1/ f/9 (Municipality) Department Division Position or Title Work telephone x2 g/// P,,1/ ç ' V2ñ g 6 73--2 & ‘st9/ 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,check here. ❑ Name and Address Nature of the Work Performed Amount of Money or of the Source of Outside Income Compensation Received /D 2 (off 7V /rA,47 ( 1 racv /yew I hereby swear(or affirm)that the information above is a true and correct statement. RECEIVED BY ELECTIONS DEPARTMENT: ) ❑ Hardcopy ❑ Electronic Copy `` 7.77 Signature of Person Disclosing _ ' �� Dat signe -:-, , OFFICE USE ONLY Accepted: Y/ N Deficiency: Processed Date/Initials: Scanned Date/Initials: 138_01-22 COE 2015