Enilda Thomas 12/31/22S
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M IA M I BEACH
City of Miami Beach
1700 Convention Center Drive
Miami Beach, Florida 33 139
OFFICE OF THE CITY CLERK
Email: BC@miamibeachfl.gov
Telephone: 305 .673 .7 411
AFFIDAVIT OF AFFILIATION WITH THE CITY OF MIAMI BEACH
srAroFL9RIDA 'aA
COUNTY OF [LA.
I am in compliance with the affiliation requirement of Miami Beach City Code Sections 2-22 (4),
as (check (/) all that apply):
~ I am a resident of the City of Miami Beach for six months or longer.
D I have an ownership interest (for a minimum of six months) in a business established in the
City of Miami Beach (for a minimum of six months).
D I am a full-time employee of a business (for a minimum of six months) and I am based in an
office or other location of the business that is physically located in Miami Beach (for a
minimum of six months).
"Ownership Interest" means the ownership of ten percent (10%) or more (including the
ownership of 10% or more of the outstanding capital stock) in a business.
"Business" means any sole proprietorship, sponsorship, corporation, limited liability company,
or other entity or business association.
Under penalties of perjury, I declare that I have read the foregoing document and that the facts
stated in it are true.
_!Ag da í.'11 serate
U la -Cg [h 4
Printed Name
Date
/2.,2i
NOTARY
Sworn to (or affirmed) and subscribed before me, by means of physical presence or online
notarization, thi s 1S'day or January
Enilda Thomas (City of Miami Beach Board/Committee Member).
FL Identification card/Non-Driver License
,20_'_by
X Produced ID
Form of Identification
Personally Known
iato4 o'9et
Signature of Notary Public_ Charles J. D'Agostin
Name of Notary, Typed, Printed, or Stamped
(NOT ARY SEAL)
A&!as,, Charles J. DAgostin 3)tS" o rAY usLuc ESTATE OF FLORIDA k±l comm cc:a171
fS .pires 12/14/2021
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