Christina LaBuzettaMIAMI BEACH
RECEIVED
City of Miami Beach
1700 Convention Center Drive DEC 0 Z 2021
Miami Beach, Florida 33139 CIS OF
oFFiC1_ OF THE I BEACH
OFFICE OF THE CITY CLERK HE CITY
Email: BC(a)miamibeachfl.gov CLERK
Telephone: 305.673.7411
AFFIDAVIT OF AFFILIATION WITH THE CITY OF MIAMI BEACH
I am in compliance with the affiliation requirement of Miami Beach City Code Sections 2-22 (4),
as (check (J) all that apply):
9f I am a resident of the City of Miami Beach for six months or longer.
Home Address: 301 Ocean Drive, Apt 304, Miami Beach, FL 33139
Ef 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).
Name of Business: Location Resources, Inc.
Business Address: 311 Lincoln Road, Suite 305, Miami Beach, FL 33139
❑ 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).
Name of Business:
Business Address:
"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.
December 1, 2021
Signature Date
Christina LaBuzetta
Printed Name
Document Ref: 9Q0Z6-NJ0NY-CVFV3-JVTCN Page 1 of 1