Génard, Jackie J. OUTSIDE EMPLOYMENT STATEMENT
MIAMwADE
~' 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
OF
2
11
1
2
Disclosure for ~~,~ 0200$
(K)(
)
.
-
1ST OF EACH YEAR IN ACCORDANCE WITH SECTION Tax Year Ending:
THE MIAMI-DADE COUNTY CODE.
Name: Last
Gleam aid First
Jack. ~ Middle
~ aeo..~~n
Filing as a (check one): ^ Miami-Dade County Employee
`
Municipal Employee of:
Position Title:
~0.~n,r1 er-~
County/Municipal Department: County/Municipal Division:
If your home address is exempt from public records pursuant Work Telephone:
to,Florida Statutes § 119.07, please check here: ^
Mailing Address (Street Name and Number
State Zip Code
Cdy ~~QWYu-- ~C_ ~31~, l0
Please list the sources of outside employment, the nature of the work and the amounts of money or other
k here: ^
h
l
ec
ease c
compensation you received., If continued on a separate sheet, p
Name and Address of the Source of
Outside Income Nature of the Work
Performed Amount of Money or
Compensation Received
_
/~ ~ --E S~ ~
`l1GuC~• ~
-1 2
l C4S~ ~S
~
~ ~~ . ~
~
00
~.J~
t ~ l J
,
.~ ~ c~
~r
n
N
~CJ~`C~ ~ ~
r- rte- 171
~ ~
N :^t'i
vi
0 3
"Tr
,.
I hereby swear (or affirm) that the aforesaid information is a true and correct statement. rte, .w
Signat a of Person Disclosing Date Signed
V
,~