Hoanshelt, Judy 6/30/6
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OUTSIDE EMPLOYMENT STATEMENT
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 ,,.--). r
1ST OF EACH YEAR IN ACCORDANCE WITH SECTION 2-11.1(K)(2) OF TaxYearEnding~OO ~
THE MIAMI-DADE COUNTY CODE.
Name: Last
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First:]\J 0'-\
MiddleYv\,
Filing as a (check one):
D Miami-Dade County Employee
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~ Municipal Employee of: 'v... r ..J
Position Title6r-eA t---JTS
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CountylMunicipal Department: ~ b {J I
CountylMunicipal Division:
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If your home address is exempt from public records pursuant
to Florida Statutes ~ 119.07, please check here: D
Mailing Addwet Na0u"!b~O 9-..
Work Telephone: . ~
sV5 .6/r-:s,.')Ot u
Apt. #
City . ,
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State
fL
"33,
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
Oul$ide Income
Nature of the Work
Performed
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Amount of Money or
Compensation Received
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I hereby swear (or affirm) that the aforesaid information is a true and correct statement.
Signature of Person Disclosin
10126/ll0
Date Signed
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