Held, Gary M.
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..~ADEt OUTSIDE EMPLOYMENT STATEM~NT
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: .200 'f
THE MIAMI-DADE COUNTY CODE.
Name: Last First Middle
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Filing as a (check one): D Miami-Dade County Employee
[B"Municipal Employee of: ;JJ /tt-/?'1/1' /3e~vL
Position Title: h IJES-t, L / d;!:; ;17' 1z; y/} e:;--
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County/Municipal Department: CountylMunicipal Division:
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If your home address is exempt from public records pursuant Work Telephone:
to Florida Statutes 9 119.07, please check here: D
Mailing Address (Street Name and Number) Apt. #
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City State Zip Code.
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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: D
Name and Address of the Source of Nature of the Work Amount of Money or
Outside Income Performed Compensation Received
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I hereby swear (or affirm) that the aforesaid information is a true and correct statement.
Signature of Person Di:~ ~C?~ Date Signed
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