Martinez, Adolfo Candelario
OUTSIDE EMPLOYMENT STATEMENT
For Full-time County and Municipal Employees
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FULL-TIME COLlNTY AND MUNICIPAl EMPLOYEES ENGAGING IN OUTSIDE
EMPLOYMENT MUST FILE AN ANNUAl DISCLOSURE REPORT BY JULY Disclosure for
1ST OF EACH YEAR IN ACCORDANCE WITH SECTION 2-11.1(K)(2) OF Tax Year Ending: )....0 ~ S-
THE MIAMI-DADE COUNTY CODE.
Name: last
First
Middle
Filing as a (check one):
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o Miami-Dad~ County Employee
~ Municipal Employee of: C f ;-
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Position Title:
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CountylMunicipal Department:.
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If your home address is exempt from public records pursuant
to Florida Statutes 9 119.07, please check here: a
Mailing Address (Street Name and Number)
City
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CountylMunicipal Divisien:
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Work Telephone:
:J 4 >- (,") ~. -7()99 JiyC &:.771
Apt. #
State
Zip Code
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
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Nature of the Work
Performed
Amount of Money or
Compensation Received
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I hereby swear (or affirm) that the aforesaid information is a true and correct statement.
Signature of Person Disclosing
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Date Si~
5/11;:
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