Bruce Carter 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: 305.673.7 41 1
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):
� a resident of the City of Miami Beach for six months or longer.
Home Address:_--¾_O=--+--L---¥---__:_/1 __ e_1_:_c�, ·11'---'11'-'--_,__---+-,______,-'-"''f----i"'�
0 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: ________________________ _
0 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 cj[IY sole proprietorship, sponsorship, corporation, limited liability company,
or other entity or buslif11!fa11ssociation.
\ ' are that I have read the foregoing document and that the facts
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Received August 29, 2022
Office of the City Clerk