Oscar Llorente 12/31/221/13/2021
City Commission
12/31/22 12/31/23
1/20/2021 11/18/2020
2/23/2021
2/23/2021
2/23/2021
Received onFeb 23, 2021Office of the City Clerk
MAM4BEA CH
City of Miami Beach
1 700 Convention Center Drive
Miami Beach, Florida 33139
O FFIC E O F TH E CITY CL ERK
Email: BC@miamibeachf]_gov
Telephone: 305.673.7411
AFFIDAVIT OF AFFILIATION WITH THE CITY OF MIAMI BEACH
STATE OF FLORIDA
COUNTY OF Miami-Dade
I am in compliance with the affiliation requirement of Miami Beach City Code Sections 2-22 (4),
as ( check (/) all that apply):
D I am a resident of the City of Miami Beach for six months or longe.,.
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).
[] lam 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 bu iness.
"Business" means any sole proprietorship, sponsorship, corporation limited liability company,
or other entity or business association.
Under penalties of pe~1'y,)I dectare that I have read the foregoing d]ument and that the facts
stated it are true. / ] ]
Sig Date
Printed Name
NOTARY
Sworn to (or affirmed) and subscribed before me, by means of X physical presence or l online
notarization, this 23rd day of February
Oscar Llorente (Ci ty of Miami Beach Board/Committee Member).
,201_by
x Produced ID FL Driver's License
Form of Identification
Personally Known
Ciad U'get
Signature of Notary Public
Charles J D'Agostin
Name of Notary, Typed, Printed, or Stamped
(NOT ARY SEAL)
Charles J. DAgostin
NOTARY PUBLIC
É sTA TE OF FL OR I D A
t/ comm GG168171 'o- c TS" Expires 12/14/2021
X
Received on Feb 23, 2021Office of the City Clerk