Antelo, Henry (2)
RECEIVED
CITY CLERK'S DEPT,
AUG 0 9 2005
.fAcet
OUTSIDE EMPLOYMENT StATEMENT
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
1ST OF EACH YEAR IN ACCORDANCE WITH SECTION 2-11.1(K)(2) OF Tax Year Ending:
THE MIAMI-DADE COUNTY CODE.
:;<005
Name: Last l
I}N'Te-o
First Middle
t-\e.-nr
Filing as a (check one):
o Miami-Dade County Employee
~ Municipal Employee of: \ of M\A.N.. \ BtA
Position Title: / ~
f1 R.K vJG EAJ FofLCeM€.N') ,Su fe-R-V I-S'O ~ L-- ff.-SlL)
County/Municipal Department: CountylMunicipal Division:
Pf1R.\Z\NG ~Fo~~N'r
If your home address is exempt from public records pursuant
to Florida Statutes 9 119.07, please check here: 0
Mailing Address (Street Name and JY.umber)
1130 Wf-\S.H\ N6TO rJ A-v
City
f\J\ \ fA lV\ \ BeA01-\
State
F) 0 R..\dA
Apt. #
I 5T PlcO
Zip Code
33137
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
S~P\~'AN SeDJRIT1*" ~ROfec..1\v,J
S~R~ \t.e-~XNt..
Lf /4 IN. "^ 'f>..."^- \ A-J -\t- 200
tv'\!\I\1\\ FL 3)/2.1
Nature of the Work
Performed
Amount of Money or
Compensation Received
-...
BV51,,,JQ..S;> OW Ne~.e.
ex ~'\P( l C-ofL fotiATt
Ore.!\A4l 0 N S
h 3D, 000 YeA ~
I hereby swear (or affirm) that the aforesaid information is a true and correct statement.
Date Signed
7//0 05
101261OO