HomeMy WebLinkAboutback-up-3CITY OF MIAMI, FLORIDA
RESIDENCY COMPLIANCE FORM
(IN CONFORMANCE WITH SECTION 2-884 OF THE CITY CODS -
Please submit your completed form to:
City of Miami
Office of the City Clerk
3500 Pan American Drive
Miami. Florida 33133
Date: 6/11/°
1, Richard W, i o',ijnserl d
\`1w3Iin,a Key Beach Park �,ri.5t
(name of board)
(l Y'Cl
a member of
cornply with the residency requirement under Code Section 2-884. namely:
(doido not)
"(a) All members of City boards shall either be permanent residents of the City, own real
property in the City, or work or maintain a business in the City..."
(Note: If you do comply, with the residency requirement (Code Sec. 2-884), please provide us with the
following information.)
A. I presently reside in the City of Miami at the following address:
B. I own a business and/or real property within the City of Miami limits at the
following address: (Note: Kindly specify if it is a business or a property)
C. I work within City of Miami limits. My business address is:
Signature