Velasco, Ana Cecilia 6/30/6
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OUTSIDE EMPLOYMENT sTlftEMi
For Full-time County and Municipal E;tl\\p1oyees
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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
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First
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Middle
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Filing as a (check one):
o Miami-Dade County Employee,
~ Municipal Employee of:
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Position Title:
1];; $'cif" '7 ,JhJ!+e:'? ~
County/Municipal Department:
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If your home address is exempt from public records pursuant
to F/orida Statutes 9 119.07, please check here: D
Mailing Address (Street Name and Number)
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City
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CountylMunicipal Division:
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Work Telephone:
3?) S- ~ '73 7 CL7{] Y & 7 ;;;t-;1
Apt. #
State
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: 0
Name and Address of the Source of Nature of the Work
Outside Income Performed
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Amount of Money or
Compensation Received
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ffjrm) that the aforesaid information is a true and correct statement.
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Date Signed
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10126/l10