Christina LaBuzetta Sep 2022City of Miami Beach
1700 Convention Center Drive
Miami Beach, Florida 33139
OFFICE OF THE CITY CLERK
Email: BC@miamibeachfl.gov
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 (✓) all that apply):
□I am a resident of the City of Miami Beach for six months or longer.
Home Address:___________________________________________________________
□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:_________________________________________________________
Business Address:_________________________________________________________
□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.
Signature Date
Printed Name
301 Ocean Dr, Apt 304, Miami Beach, FL 33139
Location Resources, Inc.
311 Lincoln Rd, Suite 305, Miami Beach, FL 33139
Christina LaBuzetta
07 / 20 / 2022
Document Ref: DEMGT-2WCDP-CBQAG-THMMP Page 1 of 1
Signature Certificate
Reference number: DEMGT-2WCDP-CBQAG-THMMP
Document completed by all parties on:
20 Jul 2022 17:08:50 UTC
Page 1 of 1
Signer Timestamp Signature
Christina LaBuzetta
Email: christina@locationresources.com
Sent:20 Jul 2022 14:11:54 UTC
Viewed:20 Jul 2022 14:11:56 UTC
Signed:20 Jul 2022 17:08:50 UTC
IP address: 172.58.188.233
Location: Washington, United States
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