Diaz, Ivette OUTSIDE EMPLOYMENT STATEMENT
MIAMFDADE
~~ For Full-time Coun and Munici al Em to ees
tY P P Y
FULL-TIME COUNTY AND MUNICIPAL EMPLOYEES ENGAGING IN OUTSIDE
EMPLOYMENT MUST FILE AN ANNUAL DISCLOSURE REPORT BY JULY Disclosure for
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 Middle
Filing as a (check one): ^ Miami-Dade County Employee
^ Municipal Employee of: ~ ~ V~ <« rr, ~~ ~e a
Position Title:
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Coun
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!f your home address is exempt from public -~eoords pursuant Work Telephone:
to Florida Statutes § 119.07, please check here: ^
Mailing Address (Street Name and Number) Apt. #
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Ciry - State Zip Code
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 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 swear (or affirm) that the aforesaid information is a true and corr+ec.K statement.
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Signature of Person Disclosing ~ Date Signed
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