Nicole ComottiM IA M I BEACH
City of Mia mi Beach
1700 Convention Center Drive
Miami Beach, Florida 33139
OFFICE OF THE CITY CLERK
Email: BC@miamibeachfl.gov
Telephone: 305.673.7411
RECEIVE D
MAY 30 2023
CITY OF MIAMI BEA CH
O FF I C E OF TH E CI TY CLERK
A F F ID A V IT O F A F F ILIA TIO N W ITH THE CITY O F M IA M I BEA C H
I am in compliance with the affiliation requirement of Miami Beach City Code Sections 2-22 (4),
as (check (/) all that apply):
D I am a resident of the City of Miami Beach for six months or longer.
Home Address: ------------------------ □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).
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,Jusiness Address:
~~~ma 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).
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"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 declare that I have read the foregoing document and that the facts 2 • « - ' €
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