Betty Behar •
RECEIVED
MIAMI BEACH APR 17 2024
C7 C y Miami Beach 1 CITY OF MIAMI BEACH
700 Convention Center Drive
Miami Beach, Florida 33139 OFF!CF Or'TLIE CITY CLERK
OFFICE OF THE CITY CLERK
Email:BCCmiamibeachfl.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 (ch (✓) all that apply):
I am a resident of the City of Miami Beach for six months or longer. n_
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Home Address: �� O 4E9o 't\C) He fU 1ttO ( I- r�
nI 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 declar that I have read the foregoing document and that the facts
state ' ar
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i a Date
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