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Roger Abramson Sep 2022MIAMI BEACH City 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 Cit of Miami Beach for six months or longer. Y �j 9 Home Address: �� ��� 0 w C / )S ` ! Z © ��-- ❑ 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: El 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: /v 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 pealties of perj I' G( 'declare that I have read the foregoing document and that the facts state ✓t are true. 2t� a 7 Z 2 Signature Date ie Printed Name