Margaret ( Peggy) Benua RE�-,F1N1
MIAMI BEACH Q. LULL
FED
City of Miami Beach C Gk{
1700 Convention Center Drive .�/ OO VA*1B`CLERK
Miami Beach, Florida 33139 Ci�1 l E E C
OFFIC
OFFICE OF THE CITY CLERK
Email: BC( miamibeachfl.gov
Telephone: 305.673.7411
AFFIDAVIT OF AFFILIATION WITH TH CITY OF MIAMI BEACH
I am in compliance with the affiliation requirement of h.' ami Beach City Code Sections 2-22 (4),
as (check (I) all that apply):
I am a resident of the City of Miami Beach for six months or longer.
Home Address:
I have an ownership interest (for a rilinimum of six months) in a business established in the
City of Miami Beach (for a minimum of six months,
Name of Business:
Business Address:
✓ 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 business that is rhysically located in Miami Beach (for a
minimum of six months).
Name of Business: Dream South Beach Hotel
Business Address: 1111 Collins Avenue, Miami Beach, FL 33139
"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.
Margaret Benua 02/08/2024
Signature Date
Margaret A Benua
Printed Name