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Janas, Robert OUTSIDE EMPLOYMENT STATEMENT MIAMFDADE ~~ 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 1 ST OF EACH YEAR IN ACCORDANCE WITH SECTION 2-11.1(K)(2) OF Disclosure for Tax Year Ending: ~Q G THE MIAMI-DADE COUNTY CODE. Name: Last First l~ot3 E T" Middle ~ Filing as a (check one): ^ Miami-Dade County Employee ~ cN°~ ~'MunicipalEmployeeof: ~i~ F ~ ._., Position Title: ~ ~ x l 0 2 ~ u Q /iU -i NS IP 7'o!L County/Municipal Department: County/Municipal Division: o = ~ N ~~u~~~NG S ~ n c ul If your home address is exempt from public records pursuant Work Telephone: ~'' to.Florida Statutes § 119.07, please check here: ©' 3 p 3 - ~~p ~ O Mailing Address (Street Name and Number) Apt. # lol . GJ ~ ~ u~-~ City State Zip Code C O ~" ~~ c 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: ^ Name and Address of the Source of Outside Income Nature of the Work Performed Amount of Money or Compensation Received ~/' I hereby swear (or affirm) that the aforesaid information is a true and correct statement. Signature of Person Disclosing ,~ Date Signed DG/ a ~ %-~~~ r_ _, v ,~~