Albury, Charles EdwardMI 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
1ST OF EACH YEAR IN ACCORDANCE WITH SECTION 2-11.1(x)(2) OF Disclosure for
Tax Year Ending: 02~ C~
THE MIAMI-DADS COUNTY CODE.
Name: Last First Middle
Filing as a (check one): ~ Miami-Dade County Employee
Municipal Employee of: ~~ g-~C fin; ~,~ ~ Q„
Position Title:
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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: ~ 3i9 ~ (oZ ~ .~ I .~ cj
Mailing Address (Street Name and Number) Apt. #
S3O '3 C'o t' ~~ ~v S
City State Zip Code
~~ IA' r'n~ 3 eec~- tr l 33 / `W
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 Amount of Money or
Performed Compensation Received
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I hereby swear {or affirm) that the aforesaid information is a true and coned statement
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Signature, Perso Disclosing
~. Date Si ned
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