Aleksandar StojanovicM IA M I BEA C H
City of Miami Beach
1 700 Convention Center Drive
Miami Beach, Florida 33139
OFFICE OF THE CITY CLERK
Email: BC@miamibeachfl.gov
Telephone: 305.673.7411
HECEIVET
JAN 18 2
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AFFIDAVIT OF AFFILIATION WITH THE CITY OF MIAMI BEACH
I am in com pliance with the affiliation requirement of Miam i Beach City Code Section s 2-22 (4),
as ( check ( ✓) all that apply):
X D I am a resident of the City of M iam i Beach fo r six months or longer.
Hom e A ddress: -------------------------- 1900 Purdy Ave #715, Miam i beach, Fl 33139
D I have an ow nership interest (fo r a minim um of six months) in a business established in the
C ity of M iam i Beach (fo r a minim um of six months).
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D I am a full-tim e em ployee of a business (fo r a minim um of six months) and I am based in an
office or other location of the business that is physically located in Miam i Beach (for a
minim um of six months).
Nam e of Business: -------------------------
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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 fo regoing docum ent and that the facts
stated in it are true.
Co LIA 1/18r2024
S ignature
Aleksandar Stojanovic
Date
Printed Nam e