Esteban Porcelli1B
City of Miami Beach
1700 Convention Center Drive
Miami Beach,Florida 33139
RECEIVED
JUL 25 2024
CITY OF MIAMI BEACHOFFICEOETIECITYCLERK
OFFICE OF THE CITY CLERK
Email:BC@miamibeachf\.gov
Telephone:305.673.7411
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):
[j tam a resident of the City of Miami Beach for six months or longer.
Home Address:3411 Indian Creek Dr.Apt.903,Miami Beach,33140
[]have an ownership interest (for a minim
City of Miami Beach (for a minimum of
of six months)in a business established in the
months).
Name of Business:ooeooooooeoeooooeooeoeeeeeeeeo~ooooooooeooooooooooooooooooooo~
Business Address:---..,p;.......---------------------
[]lam a full-time employee of a business (fora minimum of six months)and l am based in an
office or other location of the business th;"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 ar
4