Hortense De Castro (2)M IAM I BEACH
C ity o f M ia m i B e a ch
1700 Convention Center Drive
Miami Beach, Florida 33139
RECE I VE D
JUN 29 2023
CITY OF MIAMI BEACH
OFFICE O H E CITY CLERK
OFFICE OF THE CITY CLERK
Email: BC@miamibeachfl.gov
Telephone: 305 .673 7411
A F FID A V IT O F A F FILI A T IO N W IT H T H E CIT Y O F M IA M I B EA C H
I am in compliance with the affiliation requirement of Miami Beach City Code Sections 2-22 (4),
as ( check (/) all that apply): a a resident of the City of Miami Beach for six months or longer.
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0 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: --------------------------
Q/ 1 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).
N am e of Business:_0 /{ f.(AP,l t'I L.Lo a_[ ------~-+-1--------------+-J ------
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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
stated in it are true. /t.... A.C..t.
Signature
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Date
Printed Name