Aaron Bos-LunM IA M I BEACH
City of Miami Beach
1700 Convention Centor Drive
Mi am i Beach , Florida 33139
OFFICE OF THE ClîY CLERK
Em ail: BC@m iamibeachf.gov
Telephone: 305.673.7411
AFFIDAVIT OF AFFILIATION WITH THE CITY OF MIAMI BEACH
Received February 15, 2022
Office of the City Clerk
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
( ✓) a ll that ap ply):
✓I am a resident of the City of Miami Beach for six months or longer.
Home Address 1228 0 cs /vu «, Mao, au,, {-3313
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).
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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).
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"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, corp oration , limited liability com p any, 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 " „l a/is.a»-
Signa i ,' pz
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Printed Name
N O TA R Y
Sworn to (or affirmed) and subscribed before me, by means of p hy si cal presence or online notarization,
a 15th2a February ¿? Aaron Bos-Lun ------------------
(City of Mi a mi Beach Board/Committee M em ba p zpmetes;
FL. Driver's License ,.-~<J'!':&'::·¡,:;~., CHARLES J. DAGOSTIN ii ¿,¿ MY COMMISSION # HH 165705
Form of Identification Z}, ¿¿s3 EXPIRES: December 14, 2025
- Personally Known ";@jjé" Bonded Tru Notary Public Undonwtors
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Signature of Notary Public (N O T AR Y SE AL )
Name of N otar y, Type d, Printed, or Stam p e d