Cory Brown 2022DocuSlgn Envelope ID: A0243FA6-D814-4D38-BF37-79FB69AC9BF4
HIAH OUTSIDE EMPLOYMENT STATEMENT
T For Full-time County and Municipal Ermployee$
FUD -time County (inducing Public Health Trust) and Inuncipal employees engaging in outside employment must file an annual disclosure report
by Judy 1st of each year, in accordance with Section 2-11.1(k)M of the Miami -Dads County Code.
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N YW hOnre Is exempt ham pubfic records pursuant to Fiorlda Stattltae §119.07, pease see note on the foUowN page end dfedc here. ❑
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Please list the soarrces Of outside employmertt (includng self-employmenQ, the nature of the work, and the 141ST amounts of money of other
CmpeMiltion you received for each source of outsde employment. h no income or ccmpensation was received from a particular outside
employment, enter = (0) for that orgulzation in the section blow. H contlaued on a separate sheet, check here. ❑
Mame and Address
of tfine SemlrCe of Ouleadt Incomework.
Nature of the total Aruani of kun>ry or
Performed Cal Wourdw Recehed
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I hereby swear (or affirm) that the information above is a true and correct statement,
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RECEIVED IT ELECTIONS 88"nIENP.
I� Natlkopy
Electronic Copy
OFFICE USE ONLY Accepted V / N Ddlaorf PtacaseaDalowrhex,
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