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Dwight M. Nicholas 2014 • MIAMI.OIAD 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 Nicholas Dwight M Mailing Address—Street Number,Street Name,or P.O.Box 12743 SW 53rd CT City,State,Zip ID Number Miramar, FL 33027 18148 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) ® County/Public Health Trust ill Municipal Miami Beach (Municipality) Department Division Fire Department 1210 Position or Title Work telephone Captain (305) 673-7120 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. El Name and Address Nature of the Work Performed Amount of Money or of the Source of Outside Income Compensation Received Principal Financial Group 3401 SW 1601h Ave,suite 400 Financial Services 40,000 Miramar,FL 33027 I hereby sw (or affirm)that the information above is a true and correct statement. RECEIVED BY ELECTIONS DEPARTMENT: ❑Hardcopy ❑Electronic Copy Signature of rson Disclosin 1:-ll .I -Ij I \1" i'1'? A in D 5 ed 7 /26( 5� Date sig l E :1 1 !AV C I -1111 q I O? OFFICE USE ONLY Accepted: Y/ N Deficiency: Processed Date/Initials:__. Scanned Date/Initials: 138_01.22 COE 2015