Martinez, Francisco
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OUTSIDE EMPLOYMENT S~TEMENT
For Full-time County and MunicipallirmployPP~
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 Middle
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Filing as a (check one):
D Miami-Dade County Employee
0Munic;pal Employee of: C- i
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Position Title:
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CountylMunicipal Division:
CountylMunicipal Department:
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Work Telephone:
605) ~73750~
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Apt. ..
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If your home address is exempt from public records pursuant
to Florida Statutes 9 119.07, please check here: D
~iling Address (Street Name and Number) .,.1
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City
IY)( frM I
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State
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Zip Code
33/3
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.
101261110