Jonathan Freidin (2) RECEIVED
FEB �8 2024
M AM B E AC H �,,.,,oF
OFFCE OFiTHEMl B C CLERK
City of Miami Beach THE CITY
H
1700 Convention Center Drive
Miami Beach, Florida 33139
OFFICE OF THE CITY CLERK
Email:BCl miamibeachfl.aov
Telephone: 305.673.741 1
AFFIDAVIT OF AFFILIATION WITH THE CITY OF MIAMI BEACH
I am in compliance with the affiliation requirement of Miami Beach City Code Sections 2-22 (4),aas ( heck (I) all that apply):
I am a resident of the City of Miami Beach for six months or /longer. (�/� /�j
Home Address: I I iS(�vt& -f�/C/ 44. apt nautili Iw}' i e/co.AA-2 -J/ "
)
EI 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:
nI 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).
Name of Business:
Business Address:
"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 ' 't are true. /� `�
` � i2"1
Signature Date
1\ -cI(e 1kv.,,
Printed Name