Michael GoldbergM IAM IB
City of Miami Beach
1700 Convention Center Drive
Miami Beach, Florida 33139
RECEIVED
MAY 30 2023
CITY OF MIAMI BEACH
OFFICE OF THE CITY CLERK
OFFICE OF THE CITY CLERK
Email: BC@miamibeachf_gov
Telephone: 305.673.7411
AFFIDAVIT OF AFFILIATION WI TH THE CITY OF MI AMI BEACH
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.
bp[ JD]][,»
D 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: ------------------------
[[J[mes,S H([eS,
~ 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: First Horizon Bank
Business Address: 400 W 41 st Street Suite 102 Miami Beach, Fl 33140
"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 docume nt and that the facts
stated in it are true. · .. ·· . /
[7( 2,t. May 31, 2023
Signature mks.l S.
Printed Name
Date