Varon, George
RECEIVED
CITY CLERK'S DEPT.
.~A~
JJN 3 0 2005
OUTSIDE EMPLOYMENT ST~EMENT
For Full-time County and Municipal EmpFt,yees
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: d(Jo1
THE MIAMI-DADE COUNTY CODE.
Name: Last
First
Middle
,J
~~~E:
Filing as a (check one):
D Miami-Dade County Employee
ItJ Municipal Employee of: N r~: ~
Position Title:
()'-'~ &~
County/Municipal Department:
,
N,1I'nt I
If your home address is exempt from public reco~rsuant
to Florida Statutes 9 119.07, please check here: ~
Mailing Address (Street Name and Number)
" DO W,IM/h AI 'f1J1'i
County/Municipal Division:
~L
Work Telephone:
31>5 b.,3.-rJ?k X S~S
Apt. #
State
Zip Code.
City
.
N,~,
31/3
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 ofthe Source of
Outside Income
Nature of the Work
Performed
Amount of Money or
Co ensation Received
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Date Signed ":;:i .-.J
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I hereby swear (or affirm) that the aforesaid information is a true and correct statement.
10/261l1l1