Ramirez, Otto Jesus
_IDADEt 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 leo(o
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 :r
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Filing as a (check one): D Miami-Oad~ County Employee fStt\c~
EjlMunicipal Employee of: fA \A:}J\. \
Position Title: ~
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CountylMunicipal Department: CountylMunicipal Division:
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If your home address is exempt from public records pursuant Work Telephone: . 7 J 2..S
to Florida Statutes ~ 119.07, please check here:~ ,5D.r- 6'7~
Mailing Address (Street Name and Number) 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: 0
Name and Address of the Source of Nature of the Work Amount of Money or
Outside Income Performed Compensation Received
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J hereby swear (or affirm) that the aforesaid information is a true and correct statement. -
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Signature of Person Disclosing .\ ~ iJ ~ Date Signed
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10126/00
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