Miriam HaskellCity of Miami Beach
1700 Convention Center Drive
Miami Beach, Florida 33139
RECEIVED
JUL -6 2023
CITY OF MIAMI BEACH
OFFICE OF THE CITY CLERK
OFFICE OF THE CITY CLERK
Email:. BC@miamibeachfl.gov
Telephone: 305.673.7411
AFFIDAVIT OF AFFILIATION WITH THE CITY OF MIAMI BEACH AND THE COMMITTEE
FOR QUALITY EDUCATION IN MIAMI BEACH
As a voting member of the Committee for Quality Education in Miami Beach, I am in
compliance with the affiliation requirement of Miami Beach City Code Sections 2-22 (4) and
2-190.137 as.
[I] tam a City of Miami Beach resident for six months or longer.
800 Lenox Avenue, Apt. 4, Miami Beach FL 33139
Home Address.
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23-24
[le] 1am the parent/guardian of a student attending a Miami Beach school for the s chool
year,
South Pointe Elementary School
School:
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Under penalties of perjury, I declare that I have read the foregoing document and that the facts
stated in it are true. t
Signature
Miriam Haskell
6/28/23
Date
Printed Name