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Tacao, GiselaRECEIVED OUTSIDE EMPLOYMENT STATEMEN`~N ~ 9 200 MIAM FDADE ~ For Full-time County and Municipal Employees By 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. Name: Last ~/~,~ ~~1 ~"~ v First ~ /~,, ~~ U"~ Middle '"` Filing as a (check one): ^ Miami-Dade County Employee f~ ^~Municipal Employee of: ~~~ lJT ~Il~ ~~ ~ ~.°~~~~ Position Title: P~-~ ~~~ ~~~~ST County/MuniMcipAal Dgepa~rtm~~ent: c~ ~ ~pn ~, ~~t'll" V~ 1~~it"~K~ '~~/~,(,~~i 1~`illj !'nl~~ County/Mun~ic~iypal~Dii Ision: pf, ~ VGl It/ ~ ~ ~ VCS If your home address is exempt from public records pursuant to.Florida Statutes § 119.07, please check here: ^ Work Telephone: 2 ~~Qr?jQl ~ D2~3 Mailing Address (Street Name and Number) APB City y~ • State Zip CoQd~e I ~1,~~ 1 ~~ ~ ~~~~- 1 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 KA~NN~ ~~~ , ,~ N~ ~ ~-~r(,~ C;Qc~-12~%IU~%5 VA1'.co(IS ~~m~ ~~~ , ~~~1~ I hereby swear (or affirm) that the aforesaid information is a true and correct statement. Signature of Person Disclosing Date Si ed o~ ~1~~-