Hoanshelt, Judy
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MI
~ OUTSIDE EMPLOYMENT ~~1~~~~~t~~l~ I~~
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- 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
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Filing as a (check one): ^ Miami-Dade County Employee
Municipal Employee of: G T `( a'° +~'~ t ~~'"` ~ ~ ~:,1~1c- N
Position Title:
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County/Municipal Department: County/Municipal Division:
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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. #
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City State Zip Code.
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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
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I hereby swear (or affirm) that the aforesaid information is a true and correct statement.
Si re of Person Disclosing Date Signed
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