Francois Betancourt 2016MIAMFDDE OUTSIDE EMPLOYMENT STATEMENT
For Full-time County and Municipal Employees COUNTY
Last Name First Name Middle Name/Initial Disclosure for Tax Year Ending
Betancourt Francois
Mailing Address — Street Number, Street Name, or P.O. Box
10774 Cypress Bend Drive
City, State, Zip
Boca Raton, FL 33498
2016
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.
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. q
Filing as an Employee (check one)
n County n Public Health Trust U Municipal City of Miami Beach
(Municipality)
Department
FIRE
Division
RESCUE
Position or Title
Division Chief
Employee ID Number
16563
Work telephone
(305) 673 -7130
Please list the sources of outside employment (including self-employment), the nature of the work, and the total amounts of money or other
compensation you received for each source of outside employment. If no income or compensation was received from a particular outside
employment, enter zero (0) for that organization in the section below. If continued on a separate sheet, check here. 111
Name and Address
of the Source of Outside Income
Nature of the
Work Performed
Total Amount of Money or
Compensation Received
Miami Dade College
950 NW 20 ST Miami, FL 33127
Adjunct Instructor $3k yr.
I hereby swear (or affirm) that the information above is a true and correct statement. RECEIVED BY ELECTIONS DEPARTMENT:
q Hardcopy
q Electronic Copy
Signature of Person Disclosing
642 /7
Date signed
OFFICE USE ONLY Accepted: Y / N Deficiency: Processed Date/Initials: Scanned Date/Initials:
138 01-22 COE 2016