Rozenblit, Daniel Max
"ID~_ OUTSIDE EMPLOYMENT STATEMENT
For Full-time County and Municipal Employees
FULL-TIME COUNlY 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: 200(1
THE MIAMI-DADE COUNTY CODE.
Name: Last First Middle
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Filing as a (check one): o Miami-Dad~ County Employee
IS3 Municipal Employee of: jlzAM2 gcf4c#
Position Title: Jlle1B7I
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CountylMunicipal Department:/l7 CountylMunicipal Division:
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If your home address is exempt from public records pursuant Work Telephone:
to Florida Statutes ~ 119.07, please check here: 0 30 S'-b 7j- 7000 t!:x.r 6Zi/{
Mailing Address (Street Name and Number) Apt. #
203 4"0 S'tJ. 574 S'-:r/? ed! r
City State Zip Code
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f b1lM (y(C :.LtJo.f ,I:- 3.502'1
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
SignaturVf Person Disclosing Date Signed
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10/26100