Hundevadt, Robert Raymond
.'DADEt
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:
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First
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Middle
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Name: Last
Filing as a (check one):
D Miami-Dade County Employee
[SZJ Municipal Employee of: L) T'j t') v m l,qy-n I ~. t-I.
Position Title:
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County/Municipal Division:
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Work Telephone:
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County/Municipal Department:
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If your home address is exempt from public records pursuant
to Florida Statutes ~ 119.07, please check here: ~
Mailing Address (Street Name and Number)
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City
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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
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.
Date Signed c; .r:- .
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1 0/26/00