Persand, Mahendra
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CITY CLeRK'S DEPT.
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AUG 2 2 2003
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"~ADEt OUTSIDE EMPLOYMENT STA~MENT
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 XrDt("
1ST OF EACH YEAR IN ACCORDANCE WITH SECTION 2-11.1(K)(2) OF Tax Year Ending:
THE MIAMI-DADE COUNTY CODE.
Name: Last fEvLS~ First Middle
MI1He:kJbfGA- -
Filing as a (check one): D Miami-Dade County Employee
D Municipal Employee of: C. "1 r~.
Position Title: fE's. "L
County/Municipal De~artment: ( CountylMunicipal Division:
f~KLt-.J~ E ~'F ) e N r- OIL c.e y'\-\ EJ'SI
If your home address is exempt frompublic records pursuant Work Telephone:
to Florida Statutes ~ 119.07, please check here: II] (-}uS) 6 '7 ~ - cr ~ 5.3>
Mailing Address (Street Name and Number) ~. Apt. #
II ~0 ~~. 'S H A-ue-
"'"
City State Zip Code.
CMfS - FL ~Sl;;l
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 Perfonned Compensation Received
LJH \"\2 ~ S E:. L~~ ~+01t L G Itty...)j ~-c.. \J- rtJ; CC (, 1~~
~~O-S ~E. \). '> ~I
N Ml~ 1.. i r.; L~'S! g 1 C. L ~"1Ll<.. 0
I hereby swear (or affirm) that the aforesaid information is a true and correct statement.
.
Signature of Person Disclosing H.VQ I Dm~NO<
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