Stuart ReedMIAMI,BEA
City of Miami Beach
1700 Convention Center Drive
Miami Beach, Florida 33139
OFFICE OF THE CITY CLERK
RECEIVED
JAN 27 2022
CITY OF MIAMI BEACH
OFFICE OF THE CITY CLERK
Em ail: BC@m iamibeachfl.goy
Telephone: 305.673.7]] •
e
AFFIDAVIT OF AFFILIATI ON WITH THE CITY OF MIAMI BEACH ( j \
sens •• /l- p st@-to;h)
I am in compii· ce with the affili~on requirement of Mijmi Beach City Code Sections 2-22 (4), as (check
0al at a»» ' , Jafe ¡so@-k cpen
□f Mianîi ~~ch for six months or longer. r;· 1
Se._.<
Home Address _·
» I have an ownershi . in a business establish ·
Miami Beach (for a mi
Jam (9f 31S/mes
[3ys1fess J(]f@sS_heh
o I am a full-time employee of a busines
other location of the business that is phy
based in an office or
· um of six months).
[q[Te (f [[S[[]es}.a«lue
H[1g/ns,S [\(]]r}SS..ros
"Ownership Interest" means the, mership of ten percent (10%)
10% or more of the outstandir capital stock) in a business.
"Business" means any le propriet~r. hip, sponsorship, corporation, limite · bìlìty company, or other
entity or business ciation. ef)
Under penalties of2ei z, I declare/that" T%read, foregoing documer 'the facts stated in it
aree. N ,, (
too
soawre - f),, ae tar (e<4
Printed Name
NOTARY
Sworn to (or affirmed) and subscribed before me, by means of o physical presenc . tarization,
o2%JM9M1.a2 o-no tu
Name of Notary, Typed, Printed, or Stamped
3?ê ""}Wi'E $».bAGosTw
? i± I #HH 165705
%3;¢ ¿is EXPIRES: Decamber 14, 2025
"6SFi&" Bon ded Thru Notary Public Underwrit ers