Barbara Kaufman練献納憾
City of Miami Beach
1 700 Convention Center
Miami Beach, Fio「ida 33
OFFICE OF THE CITY
Email: BC miamibeach
TeIephone: 305.673.741
愈選曲
AV看丁OF AFFt」IATION WITH THE CiTY OF M漢AMI BEACH
l am in comp=ance
as (Check (/) a旧ha
二/am a resident
Home Address:
□ lhaveanowne
City ofMiami B
Name of Busin
Business Addr
□ lamafu冊me
O伸Ce Or Other
minimum of six
Name of Busin
Business Addr
“O仰ersh佃/nt
OWners母) Of lO
′偉usiness’’ me
COmpany, Or Ot
Unde「 Denalties of
ith the a制ation requi「ement of Miami Beach City Code Sections 2-22 (4),
apply):
fthe City of Miami Beach for six months or longer"
Å在 役後で /生名音∴ううノr/
Ship inte「est (for a minimum ofsix months) in a business estab=shed in the
ach (fo「 a minimum of six months).
mpIoyee ofa business (for a minimum ofsix m。nths) and i am based in an
location of the business that is physica=y located in Miami Beach (for a
months).
rest,, means the owneIS砕) Of ten percent (10%) or more thc/uding the
Or mOre Of the outstanding capita/ StOC砂/n a business.
ns any so/e prop万etorsh毎 SpOnSOrS朽), CO仰O伯tion, /imited /iab〃dy
er entity or business association・
e申ry, i declare tha= have 「ead the foregoing document and that the facts
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Date
存再生A u
Printed Name
Received December 20, 2021
Office of the City Clerk