Brendan Byrne Outside EmploymentMIAMIDAL3
COUNTY
Disclosure for Tax Year Ending Last Name
City, tate, Z ip 6 /
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Mailing Address - Street Number Street Na six P.O.x iy
2018
ame
Signat re of erson Disclosing
Date sig e
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, ()lease see note on the following page and check here. q
Filing as an Employee (check one)
q County n Public Health Trust IIII Municipal
(Municipality)
Depa tment
‘ 4 tt
Divi n
Position or Title Employee ID Number
t (g 4 20/
Work telephone
Sosr"47s7Ixs- )0 I CU -C-07ki 4i°t
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. q
Name and Address
of the Source of Outside Income
Nature of the
Work Performed
Total Amount of Money or
Compensation Received
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I hereby swear (or affirm) that the information above is a true and correct statement. RECEIVED BY ELECTIONS DEPARTMENT:
q Hardcopy
Electronic Copy
Scanned Date/Initials: OFFICE USE ONLY Accepted: Y / N Deficiency:
138_01-22 COE 2016
Processed Date/Initials: