Varon, GeorgeMIAM~ OUTSIDE EMPLOYMENT STATEMENT
~ 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: ~ N
THE MIAMI-DADE COUNTY CODE. ~ ~
Name: Last First Middle ~ ~ m
Filing as a (check one): Q Miami-Dade County Employee cr`: 'v C
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Municipal Employee of: ~l`"~ !u
Position Title: ;--, ~
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County/Municipal Department: County/Municipal Division:
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!f your home address is exempt from public records rsuant Work Telephone:
to. Florida Statutes § 719.07, please check here: s~ _ ~ ? 3.- ?77
Mailing Address (Str+eet Name and Number) Apt. #
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City State Zip Code
uiiJvL' ~ 330`Z
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 Nature of the Work Amount of Money or
Outside Income Performed Compensation Received
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hereby swear (or affirm) that the aforesaid information is a true and correct statement.
Signature of Person Disclosi ~ Date Signed
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