Villareal, Andres 6/29/06
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OUTSI,DE EMPLOYMENT STATEMENTs tJFF ICE
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
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
Filing as a (check one):
o Miami-Dade County Employee
D(J Municipal Employee of: m I AI)Jt i ~ d,
Position Title:
C
CountylMunicipal Depa
CountylMunicipal Division:
J
If your home address is exempt from public T9COITIsr:-rfUfSuant
to Florida Statutes ~ 119.07, please check here: IXJ
Mailing Address (Stl86t Name and. Number)
Work Telephone:
3oS"-'7J-7000 ~tbSSI
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Apt. #
73'1" S
City
t
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 Amount of Money or
Performed Compensation Received
<." 11"""'"'<: t ,"i- ('''N$...,tt~ $ ~. q II "
'm AA.K..t'IA!!!/'/lIJF.,";f I 26,"60'
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I hereby swear (or affinn) that the aforesaid infonnation is a true and correct statement
,. Signature of Person Disclosing
Date Signed
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