Chambers, Raymond Franklin 7/6/06
87/85/2885 85:48
.J UL -v..1b-2005 11; 43
3859932855 NES5:MIAMI BEACH:PD
C I n r'1l PJ'1 I BCH CLERK DEfT
PA(3E 81/81
305 r;'7372.:>1 P. 01/01
1.
\ ' ,
OUTSIDE EMPLOYMENT STATEMENT
For Full~time County and Munldpal Employees
,
.~. .
'. FULVTlME C~UNTY AND MUKICIPAJ. EMPl.OYEt=S ENQAGlNCi IN OUTSIDE
I EMPLOYMENT MUST FILE AN ANNUAL or~CLOSURE REPoRT BY JULY
.,1ST OF EACH YEAR IN ACCORDANCE IIJITH SECTION 2-11.1(K)(2) OF
, THE MIAMI.OADE COUN'tY CODE.
DIsclosure fat ~ S
Tax Yoar Ending: ::::::::.-. -.
Name: L3StC/f!f gd<s
Middle
r: I<. /y.
Filing ~c a (check one):
o Mi~DQdf!l County Employee
~nicipaI Employea of: CITy 0 -;::..1'111 ~ I 3acJj
I
PMliion ntle: r;)
r DJ-JC6-
CountylMunicip:1\ OQpAJ'\mBnt:
/'/II f1?'7J 86 01-1 c/i
If YOllr fJoma address j$ 6X9mpt from public r9C1J'!!.!.fU7Jent
to Florida Ststutoo S 119.07, please checK hem: 12"
Malllng AddrelS1!; (SttWt Name and. Number)
County!MlJnlcipal Division:
N) fV. D~L
Work TelephOne:
05- b 7 3-793.3
Ap\.#
state
Zip Code
City
Please list tho &ouroos.of outside employmant. the nature of the work and the amounbt of money or other
compensation yOU received, If continued on a separate sh~t,. p/~Bse chock h9r~: 0
Nan1(~ 2nd Add,"s of the Source of
"J Oublde Income
.' JA:~ J!N/e /-.,1.
~ODj<J...GIN 'f.<..oll-t,) >-/)r-r.(3oc>
'15/...lttjD-rG't<lt-s 7SD7'!
\f~gOp~ go~ ~ 1'71
NBture of the Work
Performed
Amount of MOO(lY or
ComponsatIon Rocoived
~.""
Nti,l()O~ rnfW{/<tn 1 '3~D1=' w7!JL
II' SAkf ~ ( /tn;&pJTS
U A-(tJ 6.-5 B yrtk.-
fl1&.~Jf.
I her:eby SWa$r (or affimi) that t"e aforesaid Information is B t/1.lB and correct statement.
'I
Datf! Signed
o
1Q/2M1O
TOTAL P.01