Jay, Lisa Ann
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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 Disclosure for /") ^f\4
1ST OF EACH YEAR IN ACCORDANCE WITH SECTION 2-11.1(K)(2) OF Tax Year Ending: L-GLJ
THE MIAMI-DADE COUNTY CODE.
Name: Last .,fi If
First L I iJl
Middle
G()()
D Miami-Dade County Emploxee
~ Municipal Employee of: L I~ or
Position Title: ~Y01 wr
countyl ~ iC~lrl1erOOtron
If your home address is exempt from public records pursuant
to Florida Statutes 9 119~07, please check here: D
Filing as a (check one):
rY/( a m ( 6eacJJ
Maili. n9 Address (Street Name and NumbeJl..
l~~ pg t7d-. 01-
City m l A
F0te
Zip Code
33/6y
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 0 ~
5,1'7.. ~
101261OO