Varon, George 7/6/06
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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
1 ST OF EACH YEAR IN ACCORDANCE WITH SECTION 2-11.1 (K}(2) OF
THE MIAMI-DADE COUNTY CODE.
Disclosure for ~
Tax Year Ending: ~~ 0
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Name: Last
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First
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Middle
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Filing as a (check one):
D Miami-Dade County Employee ,
g Municipal Employee of: ,.J~: ~
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Position Title: .
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County/Municipal Department:
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CountylMunicipal Division:
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If your home address is exempt from public records pursuant
to F/orida Statutes 9 119.07, please check here: ~
Mailing Address (Street Name and Number)
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Work Telephone:
( 3D5) <Jib 7- rc tJD I
Apt. #
9vH51{J(f
State
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Zip Code,
3 ?ISc/
City
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
Outside Income
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Nature of the Work
Performed
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.
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Signatu~
71
Date Signed
07-1)6" ~ok
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