Villarreal, Andres R.
.~DE!t
\
OUTSIDE EMPLO ENTi,STI~TEMENT
For Full-time County~dlM~Elpal Employees
RE,C
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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.
Name: Last
First
Middle
I
s
D Miami-Dade County Employee
~unicipal Employee of;
Filing as a (check one):
Position Title:
County/Municipal Division:
If your ho e address is exempt from public reco~~nt
to Florida Statutes 9 119.07, please check here: Ud'
Mailing Address (Street Name and Number)
Work Telephone:
. --7600 tE--x.t 6c
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
Outside Income
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Nature of the Work
Performed
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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.
Signature of Person Disclosing
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Date Signed
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10/261l1l1