Allyson Fonte 12/31/223/18/2021
12/31/22 12/31/28
3/18/2021 3/18/2021
3/18/2021
3/19/2021
3/19/2021
C ity o f M ia mi R e a c h
1 Ml/ont « ente D uve
M io : Beech florda 33139
OFFICE OF THE CITY CLERK
Email SC@miamibeach.gov
Telephone 305.573.7411
AFFIDAVIT OF AFFILIATION WITH THE CITY OF MIAMI BEACH
STATE OF FLORIDA
COUNTY OF D ami Dale
I am in compliance with the affiliation requirement of Miami Beach City Code Sections 2-22 (4),
as (check (/) all that apply):
Gr I am a resident of the City of Miami Beach for six months or longer.
O 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).
O 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.
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Signature
llyyea_ fa4
317-24 Date -
Printed Name
NOTARY
Sworn to (or affirmed) and subscribed before me, by means of [johysical presence or online
• 19th March 21 notarization, this day of,ZU_DY
Allyson Fonte (City of Miami Beach Board/Committee Member).
X Produced ID FL Drivers License
Form of Identification
, 2erso)ally Known Chao.a D'A ut,
w eueren zif aries . gosrmn
S Charles J. DAgostir
, MOT-RY PUBLIC
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Comm± GG163171
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Name of Notary, Typed, Printed, or Stamped
X
Received on March 19, 2021Office of the City Clerk