Winick, Graham 05/06
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OUTSIDE EMPLOYMENT STATEMENT
For Full-time County and Municipal Employees
FULL-TIME COUNTY AND MUNICIPAL EMPLOYEES ENGAGING IN OUTSIDE
EMPlOYMENT MUST FILE AN ANNUAL DiSClOSURE REPORT BY JULY Disclosure for ? _~ 6
1ST OF EACH YEAR IN ACCORDANCE WITH SECTION 2-11.1(K)(2) OF Tax Year Ending: c.,..u 0
THE MIAMI-DADE COUNTY CODE.
Name: last
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First
b/lA~A-cn
Middle
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Filing as a (check one):
o Miami-Dad~ County Employee
~unicipal Employee of: t:c 'l7 0 (:- JA..,- Ai+-(
ef
Posi~ Title: f
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CountylMunicipal Department: CountylMunicipal Division:
-(0<,) .e~ $\M 'k- (cJ (.1. J fJ.A <- De\.J - F (<-loA- -t- FJ'~ JJ7 ~
If your home address is exempt from public records pursuant Work Telephone:
to Florida Statutes ~ 119.07, please check here: 0 () )". 6 I S - 7 f" 7 )
Apt. #
Mailing ~~ess$(~et N~ W NUl$-
City
57~
M ( ~().A ,
State
Fe
Zip Code
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Please list the sources of outside employment, the nature of the work and the amounts of money or other
compensation you received. If continued on a separate sheet, please check here: 0
Name and Address of the Source of
Outside Income
Nature of the Work
Performed
Amount of Money or
Compensation Received
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I hereby swear (or affinn) that the aforesaid infonnation is a true and correct statement.
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