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Hoanshelt, Judy ~nln ally ~5 p~ Il: ZA MI ~ OUTSIDE EMPLOYMENT ~~1~~~~~t~~l~ I~~ ~ - For Full time County and Munlclpal Emp oyee FULL-TIME COUNTY AND MUNICIPAL EMPLOYEES ENGAGING IN OUTSIDE EMPLOYMENT MUST FILE AN ANNUAL DISCLOSURE REPORT BY .IDLY 1ST OF EACH YEAR IN ACCORDANCE WITH SECTION 2-11.1(K)(2) OF Disclosure for Tax Year Ending: 2c~~ THE MIAMI-DADE COUNTY CODE. Name: Last First Middle t-~~ t~ S ~~ ~--- j ~~--~ I~ `~ Filing as a (check one): ^ Miami-Dade County Employee Municipal Employee of: G T `( a'° +~'~ t ~~'"` ~ ~ ~:,1~1c- N Position Title: ~-~.~ ~ ~ S ~n +~- ~ ~~ ~ 2 County/Municipal Department: County/Municipal Division: ~Z ~c'_'~v~`~ If your home address is exempt from public records pursuant Work Tele hone: '~ ~ (~ 3 to Florida Statutes § 719.07, please check here: ^ (~j O ~S~ ~~ 3 = 1G~ C~ Mailing Address (Street Name and. Number) Apt. # y- 2C~ uJ 3 ~ i ~ S i ~ ~ ~ City State Zip Code. t'L'~ 1-t'~-M t ~ ~~-1-~ ~--}'_ ~~ ~ l ~~ 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 sheets please check here: ^ Name and Address of the Source of Nature of the Work Amount of Money or Outside Income Performed Compensation Received ~i~ ~ 1 l~ (~-~1~-L ~ ~ I i c~ ~ ~ ~-2 C~ ~ ~~~ 1v ~ S M ~:n~,~, N ~ . ~ SS~ct -~ ~ r ~ 1~ x t 1! Mw ~' '`~. ~ ,4 ~~~ ~~ I hereby swear (or affirm) that the aforesaid information is a true and correct statement. Si re of Person Disclosing Date Signed --7 ~12~~ O / ,azs,oo ~,~,~C - 7~'