Hasburn, Jorge
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
1 ST OF EACH YEAR IN ACCORDANCE lMTH SEcTIoN 2-11.1 (K)(2) OF Tax Year Ending:
THE MtAMl-DADE CouNTY CODe.
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First Middle
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O Miaml-Dade County Employee
~icipal Employee of: Ilt /lwJ I' ~ r:'h<u?1
Fling as a (check one):
Position Title:
Ilc.EYVJ -e~~/} J
Zip Code.
3:30/
Please fISt the soun:8s 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
State
N81ft8 and Address of the Source of
OUtside Income
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NlIture of the Work
Perfonned
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Amount of lIoney or
Compensation Received
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I hereby swear (or
id information is a true and correct statement
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