Yolanda SanchezCity of Miami Beath
1700 Convention Center []rive
Miami Beach, Florida 33139
OFFICE OF THE CITY CLERK
Email:miam. b �
Telephone: 305.673. 1 1
AFFIDAVIT OF AFFILI
TION WIT
HE CITY OF
IIAMI BEACH
am in compliance with the affiliation requirement of Miami Beach City Code Sections 2-22 (4),
as (checkAV*�) all that apply):
anti a resident of the City of Miami Beach forsix months or longer,
Home Address:: ��� � � . }-1 Z Oq
have an ownership interest (dor a minimum of six months) in a business established in the
pity of MiamiBeach (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 1 am bayed in an
office or other location of the business that is physically located in Miami beach afar a
minimum of six months),
Name of Business..
Business Address:-
"Ownership
Interest" means the ownership of fen percent (10%) or more (including the
ownership of 10% or more of the outstanding capital stock) in a business.
"Business" means any sole proprietorship, sponsorshijOr corporation, limited liability company,
or other entity or business association.
Ur er penalties of perjury, I declare that I have read the foregoing document and that the facts
1 at�;d in rt true' 7
nature
Pfl'nted Name
00-11
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Date