Ratner, Thomas Edward
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.~~t OUTSI.DE EMPLOYMENT STATENIE!NT
For Full-time County and Municipal Employees
FULL-TIME COUNTY AND MUNICIPAL .EMPLOYEES ENGAGING IN OUTSIDE
EMPLOYMENT MUST ALE AN ANNUAL DISCLOSURE REPORT BY JULY Disclosure for L 00 ( /?
1ST OF EACH YEAR IN ACCORDANCE WITH SECTION 2-11.1(K)(2) OF Tax Year Ending:
THE MIAMI-DADE COUNTY CODE.
Name: Last First Middle
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Filing as a (check one): D Miami-Dade County Employee
5J Municipal Employee of: . IJ1 ( 4-Yn I e~tl
Position TiDe:
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CountylMunicipal Department CountylMunicipal ~jn:
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If your home address is exempt from public recoUlSuant Work Telephone:
to Florida Statutes ~ 119.07, please check here: V ,1'0\ - 07c~ -7ono ~ fo<;rS
Mailing Address (Street Name and. Number) Apt. #
City 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: D
Name and Address of the Source of Nature of the Work Amount of Money or
Outside Income Perfonned Compensation Received
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I hereby swear (or affirm) that the aforesaid information is a true and correct statement.
. Signature of Person DiSClo~ /' Date Signed
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