Alon AlexanderCity of Miami Beach
1700 Convention Center Drive
Miami Beach, Florida 33139
OFFICE OF THE CITY CLERK
Email: BC cDmiamibeachfl.gov
Telephone: 305.673.741 1
AFFIDAVIT OF AFFILIATION WITH THE CITY OF MIAMI BEACH
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
(✓) all that apply):
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I am a resident of the City of Miami Beach for six months or longer,
Home Address 3451 N Meridian Ave
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 decl a that I have read the foregoing document and that the facts stated in it
are true. - 1/11/23
Signature Date
Alon Alexander
Printed Name
NOTARY %�'
Sworn to (or affirmed) and subscribed before me, by means of ,"physical presence or ❑ online notarization,
this � day of �1 dry& %irt 20 by �r1 t{'X�%r
(City of Miami Beach Board/Committee Member).
Produced ID
Form of Identification
personally Known
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Name of Notary, Typed, Printed, or Stamped
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My Comm. Expires Apr 26, 2026
Banded through National Notary Assn.