Francois Betancourt 2018Last Name First Name Middle Name/Initial Disclosure for Tax Year Ending
Betancourt Francois
Mailing Address — Street Number Street Name, or P.O. Box
2300 Pine Tree Drive
City, State, Zip
Miami Beach, FL 33140
2018
OUTSIDE EMPLOYMENT STATEMENT
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.
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.
Rftg as an Employee (chock ono)
n County n Public Health Trust Municipal City of Miami Beach
(Municipality)
Department
Fire
Division
Fire Suppression
Position or Title
Division Chief
Employee ID Number
16563
Work telephone
(305) 673-7118
Please list the sources of outside employment (including se f-employment), the nature of the work, and the total amounts of money or other
compensation you received for each source of outsioe 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. q
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 20th ST
Miami, FL 33127
EMS Adjunct Instrcutor $50 hourly
I hereby swear (or affirm) that the information above is a true and correct statement.
Signature of Person Disclosing
6120/9
Date signed
RECEIVED BY ELECTIONS DEPARTMENT:
Hardcopy
Electronic Copy
OFFICE USE ONLY Accepted: Y i N Deficiency: ___ Processed Date/Initials:
13801-22 COE 2016
Scanned Date/Initials: