Blanco, Luis A. 6/13/06
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..~dt OUTSIDE EMPLOYMENT STATEMENT ',.,C
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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 t tJlJ ~
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
~ Municipal Employee of: (;Z'"/y oF" MA/l1/ ~d.
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Position Title: ~c;..h"'A/""e-A L
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CountylMunicipal Department County/Municipal Division:
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If your home address is exempt from public records pursuant Work Telephone:
to Florida Statutes 9 119.07, please check here: ~ .3f:25'=- tP73-7&:1Da ~ G:. 7-S0.
Mailing Address (Street Name and, Number) Apt. #
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City M~'"4/ ~ 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: 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 Disclosing Date Signed
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