Martell, James OUTSIDE EMPLOYMENT STATEMENT
MIAMtDADE
~~ 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.
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Filing as a (check one): ^ Miami-Dade County Employee
Municipal Employee of: ~t~ ~ m ~~ ~ ~ B.~~~h
Position Titfe:
County/Municipal Department: County/AAunicipal Division:
/f your home address is exempt from public records pursuant Work Telephone:
to Florida Statutes § 119.07, please check here: ^ ~ c~ ~' - ~ '"7 3 -- `7 O C~ U
Mailing Address (Street Name and. Number) Apt. #
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Cky ~ State Zip Code.
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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 sheep please check here: ^
Name and Address of the Source of Nature of the Work Amount of Money or
Outside Income Pertormed Compensation Received
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I hereby swear (or affirm) that the aforesaid information is a true and correct statement.
Dis
closing
Signature of Person Date Signed
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