Gutierrez, Maria 2004
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OUTSIDE EMPLOYMENT STATEMENT
For Full-time County and Municipal Employees
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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.
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Name: Last
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First
MAR-,'A
Middle
C
Filing as a (check one):
D Miami-Dade County Employee
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!5n.Municipal Employee of: C (1(' oF' ,MIrrA ( t;7f7/t-e-U
Position Title:
AAI
County/Municipal Department:
CountylMunicipal Division:
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Work Telephone:
(3D ~ C; (, 2U
Apt. #
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If your home ad ress is exempt from public records pursuant
to Florida Statutes 9119.07, please check here: D
Mailing Address (Street Name and Number)
City
State
Zip Code
Please list the sources of outside employment, the nature of the work and the amounts of money or other
compensation you received. If continll9d on a separate sheet, please check here: D
Name and Address of the Source of
Outside Income
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.
Signatur of Person DiSCIO~
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