Garcia, Adonis, L. OUTSIDE EMPLOYMENT STATEMENT
MIAMFDADE
~~ 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
Disclosure for GU~~
1ST OF EACH YEAR IN ACCORDANCE WITH SECTION 2-11.1(K)(2) OF Tax Year Ending:
THE MIAMI-DADE COUNTY CODE.
Name/: Last First
~ Middleqe
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Filing as a (check one): ^ Miami-Dade County Employee
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Municipal Employee of:
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 Telephone:
to.Florida Statutes § 119.07, please check here:
Number) Apt. #
Mailing Address (Street Name and
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Chy St a Zip Code
M°l~~( ~'~.~~, ~ 332
Please list the sources of outside employment, the nature of the work and the amounts of money or other
compensation you received. li continued on a separate sheet, please check here: ^
Name and Address of the Source of
Outside Income Nature of the Work
Performed Amount of Money or
Compensation Received
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I hereby swear (or affirm) that the aforesaid information is a true and correct statement. 0 3 .71
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Signature o son Dis Ing
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