Robyn Malek (2)IBE H
City of Miami Beach
1700 Convention Center Drive
Miami Beach, florid 33139
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JUL 20 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 WITH THE CITY OF MIAMI BEACH
l am in compliance with the affiliation requirement of Miami Beach City Code Sections 2-22 (4),
as (check (/) all that apply):
~dent of the City of Miami Beach for six months or longer.
Home Address:_]]] HB,FL 33/356
1 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).
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D 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 busine ss that is physically located in Miami Beach (for a
minimum of six months)
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Business Address:
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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
state in it are true, ,.,,,,.,.,,,,, , /4 1,
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