Allison ButtacavoliMIAMIBEA H
City of Miami Beach
1700 Convention Center Drive
Miami Beach,Florida 33139
OFFICE OF THE CITY CLERK
Email:BC@miamibeachfl.goy
Telephone:305.673.7411
RECEIVED
AUG 1 6 2024
CITY OF MIAMI BEACHOFFICEOFTHECITYCLERK
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):
15(}1 am a resident of the City of Miami Beach for six months or longer.
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[]1have an ownership interest ((or 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:------------------------
[[1am 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 aminimumofsixmonths).
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"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.
,I declare that I have read the foregoing document and that the facts
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