Bugallo, Arnaldo OUTSIDE EMPLOYMENT STATEMENT
MIAMEDADE
~~ For Full-time County and Municipal Employees
FULL-TIME COUNTY AND MUNfCIPA1 EMPLOYEES ENGAGING IN OUTSIDE
EMPLOYMENT MUST FILE AN ANNUAL DISCLOSURE REPORT BY JULY Disclosure for
1ST OF FJiCH YEAR IN ACCORDANCE WITH SECTION 2-11.1(K)(2) OF Tax Year Ending: ~
THE MIAMI-DADE COUNTY CODE. ~ --~+
me: La First Middle
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Filing as a (c k one): ^ ami-Dade County Empl _---, G~ ~'
Municipal Employee of: -`'
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ty/Municipal ment: ~~
L ~L./ r County/Municipal Division:
If your home add ess is exempt f m public records p cant Work Telephone:
to Florida Statcttes § 119.07, please check here: ~ q ~~. ~'',
Mailing Address (Street Name and Number) - ~ Apt. #
City State Zip Code
Please list the sources of outside employment, the nature of the work and the amounts of m!~y c- o*.!:er
col~p2nsation you received. if carrtinued 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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I hereby I(or affirm) that the aforesaid information is a true and correct statement.
Si ature erson Disc using Date Signed
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