Erbs, Robert L. 6/6/6
.Jt&t OUTSI,DE 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
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 ~cw1 Middle
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Filing as a (check one): o Miami-Dade County Employee
rgJ Municipal Employee of: ~.~
Position Title: ~ ~ 1
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CountylMunicipaJ Department CountylMunicipal Division:
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If your home address is exempt from public recon::Is pu~uant Work Telephone:
to Florida Statutes 9 119.07, please check here: ~ ~<) lo'7~ I , 'l. S
Mailing Address (Street Name and, Number) Apt. #
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City State Zip Code.
/1,1"0..(2;;> YL- '3'J I ~ c;'
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 Nature of the Work Amount of Money or
Oul$ide Income Perfonned Compensation Received
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I hereby swear' (or affirm) that the aforesaid ~~n ,is a true'and' correct statement.
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, Signatu~iSCIOSing <3 \ :8 \;j \j I \ill .;1,,' Date rignE~
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