Hasbun, Jorge 2004
iiiOADEt
-OUTSIDE EMPLOYMENT STATEMENT
For Full-time County and Municipal Employees
Fi.JLL-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: ~ S
THE MIAMI-DADE COUNTY CODE.
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Filing as a (check one):
o Miami-Dad~ County EmPIOY~
~ Municipal Employee Of{!; ,
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County/Municipal Department:
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If your home address is ex mpt from public records pursuant
to Florida Statutes S 119,07, please check here: 0
County/Municipal Division:
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Work Telephone:
305 f:;,73- C;'<.!-~~
Apt. #
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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: 0
Name and Address of the Source of Nature of the Work
Outside Income Performed
Amount of Money or
Compensation Received
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I hereby swear (or affi
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,
aforesaid information is a true and correct statement.
10/26/00