Merle ShamaMI
City of Miari B al
1700 Convenfin! O«iv
Miami Beach, Fila 3139
RECEIVED
/UN 26 2024
92%%2%.%%
OFFICE OF THE I Y IEE
Email: BC@mnil a /if gov
Telephone: 305 373.7 1
£ FE DAy[TE LEE!L,IAIN_ y/ITH IHE CIT OF MIAMI BEACH
I am in comp'ace wila the afi tin requirement of Miami Beach City Code Sections 2-22 (4),
as (check ()al tl at apply
CJ' , am a n i:,,i1: ar I cf the City o: Mi,nni Beach for six months or longer.
one.a. / 1Ghana /t @I,MB3 FL 33137 -· " ···---·· ·-···-·-" 5 )
E[1have awar rslii ntarest(r a miimum of six months) in a business established in the
City of Mia i "ea;i (fora ririmum of six months).
E_]1am a full-im employee nosiness (for a minimum of six months) and I am based in an
office or hie loaton oi th business that is physically located in Miami Beach (for a
minimum l si: mrths}.
Name o B 1si ass:
"Ownership /nras! mean, tve ownership of ten percent (10%) or more (including the
ownership c' 1% 9r rare o"tho outsranding capital stock) in a business.
"Business' en ary sole yrorietorsnip, sponsorship, corporation, limited liability company,
or other crdry or musirvs assccation.
Under penalti of rjury, I declare that l have read the foregoing document and that the facts
stated jn it are J,€ . --··-··&~ ·-----··--
srsre Mlle hauq Date 1