Ratner, Thomas E.
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,(:O(JTSFoE EMPLOYMENT STATEMENT
MIAMfADEt: ";" \.'
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- -' : I 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 2004
1ST OF EACH YEAR IN ACCORDANCE WITH SECTION 2-11.1{K)(2) OF Tax Year Ending:
THE MIAMI-DADE COUNTY CODE.
Name: Last First -J. Middle
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Filing as a (check one): D Miami-Dade County Employee . J /tU~tI~'
Q Municipal Employee of: r~ {. II 4-#
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Position Title:
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County/Municipal Depalment: CountylMunicipal Division:
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If your home address is exempt from publiC feCOwuant Work Telephone:
to Florida Statutes 9 119.07, please check here: ,,:To \- -'73 - 7000 )L ~ o~-J
Mailing Address (Street Name and Number) Apt. #
City State Zip Code
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.
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Signature of Person Disclosing ~/ Dme,~
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