Joshua LifshultzCity of Miami Beach
1700 Convention Center Drive
Miami Beach,Florida 33139
OFFICE OF THE CITY CLERK
Email:BC@miamiheachf\.govTelephone:305.673.7411
RECEIVED
JUL 24 2024
CITY OF MIAMI BEACHOFFICEOFTHECITYCLERK
AFFIDAVIT OF AFFILIATION WITH THE CITY OF MIAMI BEACH
l am in compliance with the affiliation requirement of Miami Beach City Code Sections 2-22 (4),
as (check ()all that apply):
[lg tam a resident of the City of Miami Beach for six months or longer.
Home Ad@r 2498 Prairie Avenue MB FI 33140
[thave 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).
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P[IS,[[]PMS,J\]H·,,_.....r.
[l tam 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 o Bosa.Finnegan's Way
osmess A@rs.1344 Ocean Dr MB FI 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"moans 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.
Joshua Lifshultz
Signature
Printed Name
7/23/2024
Date