Grant, Willie 6/1/06
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OUTSlQe;EMPL()~T STATEMENT
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 .-, rTrl,~
1ST OF EACH YEAR IN ACCORDANCE WITH SeCTION 2-11.1(K)(2) OF Tax Year Ending: ~ UV '. ~
THE MIAMI-DADE COUNTY CODe.
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Filing as a (check one):
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Position Title:
City
----
Zip Code.
If your home address is exempt ~ public t8COIfls
to FIorids Statutes 9 119.07, please checJc here:
Mailing Address (Street Name and. N bar)
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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: 0 .
Name and Address of the Source of
Outside Income
Nature of the Work
Perfonned
Amount of Money or
Compensation Received
resaid Infomlation Is a true and correct statement.
DateSig ed
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101'lll000