David SuarezBE
City of Miami Beach
1700 Cornficn Contor Drive
Mimi Beach, Florid3 33139
OFFICE OF THE CITY CLERK
Em
Talphona:
RECEIVED
MAR 1 2023
CITY OF MIAMI BEACH
OFFICE OF THE CITY CLER K
AFFIDAVII OF AFFILIATION WITH THE CITY OF MIAMI BEACH
STATE OF FLORIDA
COUNTY OF MIAMI-DADE
l am in compliance with the aflllaton requirement of Miami Beach City Code Secti on s 2-22 {4), as (check
(/) alt that apply)
l am a resldent at the City of Miami Beach tot six month s or longer.
Hor Asano '700 MERIDIAN AVE, UNIT 101. MIAMI BEACH, FL 33135
0 have an ownership interest (for a minimum of sl months) in a business established in the City of
Miami Bech (far a minimum of six months).
Business ddre%$»
DI I am a fut-time employeo 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}
Ownership trtorest" megns the ownership of ten per~et (10%) or more (nciading the ownership of
1% or mono of the outstanding capital stock) in a pusloss.
'Busine ss" mesas any sale propnetcrship, spanscrstip, corporation, limited liability company, or other
ntity or business as
e that I havo road the foregoing document an d that the facts stated in it
3/1/2023
Signature
DAVID SUAREZ
Deale
Printed tam e
NOTARY
Sworn to (or affirmed) and subscribed before me, ty means of a physical pr&sens or u onlin notarization,
(NOTARY SEAL )
Name of Notary, Typed , Printed, or Stam ped · 4 Florida
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