Amani AyersM IAMI BEACH
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
JUN 21 2023
CITY OF MIAM I BEA CH
OFFICE OF TH E CITY CLERK
AFFIDAVIT OF AFFILIATION WITH THE CITY OF MIAMI BEACH
I am in compliance with the affiliation requirement of Miami Beach City Code Sections 2-22 (4),
as (check(✓) all that apply):
✓iam a resident of the City of Miami Beach for six months or longer.
UL [e (z ri, <339 Home Address: /000
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: -------------------------
Business Address: -------------------------
~ 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:_~~-Vv\-~~-------Ai---~--·_c._ ..... f_A _
unos A«ares far"- 'Pe esr v~ re_Ras
"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
ya6we
-~____.____._____.__"'Vvt-!_-----L-.~-"-V--µ_I _ 0 / 0 ~ 2 ~
Signature Date
A, poi /ye@u
PrirleG Name