Varon, George OUTSIDE EMPLOYMENT STATEMENT
MIAMhDADE
~' 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
OF
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2 Disclosure for
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1 ST OF EACH YEAR IN ACCORDANCE WITH SECTION Tax Year Ending:
THE MIAMI-DADE COUNTY CODE.
Name: Last First Middle
Filing as a (check one): ^ Miami-Dade County Employee
Municipal Employee of: /y~A+'w'
Position Title:
County/Municipal Department: County/Municipal Division:
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if your home address is exempt from public records purl nt Work Telephone:
to Florida Statutes § 119.07, please check here: ~ 3 !~ ~7 3 ~ O /
Mailing Address (Street Name and Number ~ ~ Apt. #
~ 8 7 S C/~:crec
Cry State Zip Code,
wv~~ ~ 33 ~/
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 sheely please check here: ^
Name and Address of the Source of Nature of the Work Amount of Money or
Outside Income PerFor
med Compensation Received
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I hereby swear (or affirm) that the aforesaid information is a true and correct statement.
Signature of Pe Disclos' Date Signed
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