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Victor White 2018MUkMI•DA.DE 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. Disclosure for Tax Year Ending Last Name First Name Middle Name/Initial 2018 White Victor A Mailing Address — Street Number, Street Name, or P.O. Box 8337 SW 182 Terrace City, State, Zip Palmetto Bay, FL 33157 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 El Public Health Trust r7l Municipal Miami Beach (Municipality) Department Division Miami Beach Fire Department Suppression Position or Title Employee ID Number Work telephone Lieutenant 19545 (305) 673-7120 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. ❑ Name and Address of the Source of Outside Income Nature of the Work Performed Total Amount of Money or Compensation Received American Medical Academy 12215 SW 112 Street Miami, Florida 33186 Instructor for EMT and Paramedic programs 3,000 I hereby swear ("affirm) that/the information above is a true and correct statement. Signature of Person Disclosing 2 M� Date signed RECEIVED BY ELECTIONS DEPARTMENT: ❑ Hardcopy ❑ Electronic Copy OFFICE USE ONLY Accepted: Y / N Deficiency: Processed Date/Initials: Scanned Date/Initials: 13801-22 COE 2016