Lupien, Paul OUTSIDE EMPLOYMENT STATEMENT
MIAMWADE
~~ For Full-time County and Municipal Employees
FULL-TIME COUNTY AND MUNICIPAL EMPLOYEES ENGAiGING IN OUTSIDE
EMPLOYMENT MUST FILE AN ANNUAL DISCLOSURE REPORT BY JULY DiSClosure foi ~ oo /' "
1ST OF EACH YEAR IN ACCORDANCE WITH SECTION 2-11.1(K)(2) OF Tax Year Ending: ~/
THE MIAMhDADE COUNTY CODE.
Name:/Last ~ . Fi
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Filing as a (check one): ^ Miami-Dade County Empl
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Q Muniapal Employee of: T /'/ ~A~ 1 /~~s~~+~1_
Position Title: /
County/Municipai Department: County/Municipal Division:
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If your home address is exempt from public records pursuant Work Telephone:
to Florida Statutes § 119.07, please check here: ~ ..3~ S' ~ 7~ 777(0 _ ~ Q
Mailing Address (Street Name and Number) ~• #
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 n3ceived. if continued on a separate sheet please check here: ^
Name and Address of the Source of Nature of the Work Amount of Money or
Outside income Performed Compensation Received
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i hereby swear (or affirm) that the aforesaid information is a true and correct statement. ~ cat
Signatu f Person i 'ng ~---~ Date Signed ~ ~_
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