Stacy SavettMIAMI BEACH
RECEIVED
SEP 23 2024
CITY OF MIAMI B6ii-ea22
City of Miami Beach
1700 Convention Center Drive
Miami Beach,Florida 33139
OFFICE OF THE CITY CLERK
Email:.BC@miamibeachfl_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(✓)all that apply):y..resident of the City of Miami Beach for six months or longer.
o»we»a0,r Nl to Rees,(30
[]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:_
D 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.
siness"means any sole proprietorship,sponsorship,corporation,limited liability company,
er entity or business association.
ry,I declare that I have read the foregoing document and that the facts
Signature See,«er#Date I
Printed Name