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Elizabeth Latone MIAMI BEACH RECEIVED City of Miami Beach FEB 26 2024 1700 Convention Center Drive CITY OF MIAMI BEACH Miami Beach, Florida 33139 OFFICE OF THE CITY CLERK OFFICE OF THE CITY CLERK Email: BC(amiamibeachfl.gov Telephone: 305.673.7411 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), as (check (J) all that apply): ?`-d am a resident of the City of Miami Beach for six months or longer. Home Address: �-(>;' L; c. { � L` }r 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). 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 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 in it are tr Signature Date Printed Name