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Dean Chambers 2014 MIAMI- DE, 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 Chambers Dean Mailing Address—Street Number,Street Name,or P.O.Box 1475 NE 121st ST. Apt. C408 City,State,Zip ID Number North Miami, FL 33161 20565 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 a(check one) ❑ County/Public Health Trust II Municipal City of Miami Beach (Municipality) Department Division Communications Communications Position or Title Work telephone Visual Comm. Specialist (305) 673-7575 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 Savannah State University Teaching $700 3219 C011ege St.Savannah,Ga.31404 I hereby swear(or affirm)that the information above is a true and correct statement. RECEIVED BY ELECTIONS DEPARTMENT: -['Hardcopy ❑Electronic Copy Signature of Pe ,( losing SJ2 /ec Date signed 1 0/1 :2 Wd .. W SIR OFFICE USE ONLY Accepted: Y/N Deficiency: Processed Date/Initials: n a Scanned Date/Initials: r i 138_01-22 COE 2015