Amanda KnappM IA M IB
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
RECEIVED
MAR 2203
IIY OF MIAMI BEACH
OFFICE OF TH cir cLEnk
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): ·¥ I am a resident of the City of Miami Beach for six months or longer.
tor e A«ae. [%o Ile@ Aue /4A9 1
□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.
_~_r:_dt_r~...,.~_-_,_t~ie_s_o_f_p_e-rj-ur-y~, --~--t-ha_t_l_h_a_v_e-rnad the foregoing ~g;:;-;at the facts stated in ii
Signal Ir Date
Amanda Knapp
Printed Name
NOTARY
Sworn to (or affirmed} and subscribed before me, by means of□physical presence or online notarization,
» l ay ot Morh .2o2• A0on-do k-ow p
_________ (City of Miami Beach Board/Committee Member).
/ oaoeeao \nyea Lu c@re€
llfµo of Identification
Person II K w
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signature or Ray Pie
Name of Notary, Typed, Printed, or Stamped