Trujillo, DanielRECEIVED
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~ OUTSIDE EMPLOYMENT STATEMEN~'~N 2 g 20
~ For Full-time Coun and Municipal Employees
FULL-TIME COUNTY AND MUNICIPAL EMPLOYEES ENGAGING IN OUTSIDE '~m@
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 MiAMhDADE COUNTY CODE.
Name: Last Fist Middle
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Filing as a (check one): ^ Miami-Dade County Empl
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~Muniapal Employee of: C..I ~ ~-1 ~ r"` ~ ~~~ ~~
Position Title:
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County/Municipal Department: County/Municipal Division:
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If your home address is exempt from public records pursuant
^ Work Telephone: _
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to Florida Statutes § 119.07, please check hem: ~,~ j~ t
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Mailing Address (Street Name and Number) Apt. #
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City State Zip Code
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Please list the sources of outside employment, the nature of the worts and the amourrts of matey or other
compensation you received. !f continued on a separate sheet, please check hem: ^
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 (a• affirm) that the aforesaid information is a true and correct statement.
Sign re of Perso losing Date Signed
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