Coakley, Michael 5/31/06
MIAMD
OUT51.DE EMPLOYMENT 5T A TEMENT
For Full-time County and Municipal Employees
FULL-TIME COUNTY AND MUNICIPAL 'EMPLOYEES ENGAGING IN OUTSIDE
EMPLOYMENT MUST ALE 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
G
First Middle
~MCk\tlt~C
Filing as a (check one):
D Miami-Dade County Employee
~ Municipal Employee of: (~ l .~~
Position Title: I
CCK1.t Cbtv'tJ' ( ~ e...t.. C (l t.10
CountylMunicipal De'18rtment .
CCv6t' \CA( EtI'-./t
If your home address is exempt from public reco'!!!-fUrsuant
to Florida Statutes 9 119.07, please check here: U
Mailing Address (Street Name and. Number)
u
fVh 4t;,-l,
6c~
County/Municipal Division:
Work Telephone: .~
~YJ) -Cr'7') - 7SS-~
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 checJc here: 0
Name and Address of the Source of
Oul$lde Incorne
Nature of the Work
Perfonned
Amount of Money or
Compensatl Received
I hereby swear (or affirm) that the aforesaid information is a true and correct statement.
Date Signed
~ 61 t6h
1012M10