Fernandez, Carlos 6/29/06
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O'~ Jl\1;!?9 PI; 3: 31
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OUTSI.DE EMPLOYMENT STA"'EME'NfFF
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 Q...C)D S-
1ST OF EACH YEAR IN ACCORDANCE WITH SECTION 2-11.1(K){2) OF Tax Year Ending: ..,
THE MIAMI-DADE CouNTY CODE.
Name: Laste I . t
1 \.V~ ~Ncl-g,.
A~A-~S
Middle
~
Filing as a (check one):
D Miami-Dade County Employe~
[2J.Municipal Employee of:
~.~.~
:/-ap-
Position Title: LJ- \' r
-"C.-fV f:r.l V Q Q... g. I IV
Co~ tylM"K'icip,al Dep~rtment.. { ,
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If your home address is exempt from public recotds pursuant
to Florida Statutes ~ 119.07, please check here: I25l
Mailing Address (Street Name and. Numbe,*,
.'3{ ,/-0 S:.. ~~ !}p
City
+tA-~M J!{-lR
Sta~c
Apt. #
J I Oq
Zip Code,
~~Oc?
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 sep8l8te sheet, please check here: D .
Name and Address of the Source of
Outside Income
Nature of the Work
Perfonned
Amount of Money or
Compensation Received
N)A
I hereby swear (or affirm) that the afo
tidn is a true and correct statement.
..Signature of Person Disclosing
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