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2006-102
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2006-102
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Last modified
7/26/2016 4:27:10 PM
Creation date
9/30/2015 9:36:54 PM
Metadata
Fields
Template:
Official Documents
Official Document Type
Agreement
Approved Date
03/30/2006
Control Number
2006-102
Agenda Item Number
Administrators signature
Entity Name
Shadowbrook Estates, Inc.
Subject
Option Agreement for sale and purchase -LAAC Project South Prong Slough
Supplemental fields
SmeadsoftID
5565
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ADDENDUM <br />BENEFICIAL INTEREST AND DISCLOSURE AFFIDAVIT <br />(OTHER) <br />STATE OF ) <br />COUNTY OF ) <br />Before me, the undersigned authority, personally appeared PIERRE PAQUETEE, President of Shadowbrook Estates, Inc., <br />a Florida corporation, this day of 2006, who, first being duly sworn, deposes and says: <br />1) That SHADOWBROOK ESTATES, INC., a Florida corporation, 5865 Pine Ridge Circle, Vero Beach, Florida, 32967, is <br />the record owner of the Property. The following is a list of every "person" (as defined in Section 1.01(3), Florida Statutes) <br />holding 5% or more of the beneficial interest in the Property: (if more space is needed, attach separate sheet) <br />Name <br />Address <br />S,n(a9w coo k L` S4 ��eS ' 1 <br />Interest <br />2) That to the best of the affiant's knowledge, all persons who have a financial interest in this real estate transaction or <br />who have received or will receive real estate commissions, attorney's or consultant's fees or any other fees or other benefits <br />incident to the sale of the Property are: <br />Name Address Reason for Payment Amount <br />S�nAtOpc9Dk ES�i2Si <br />(4c- <br />3) <br />dC <br />3) That, to the best of the affiant's knowledge, the following is a true history of all financial transactions (including any existing <br />option or purchase agreement in favor of affiant) concerning the Property which have taken place or will take place during the <br />last five years prior to the conveyance of title to Shadowbrook Estates, Inc: <br />Name and Address <br />of Parties Involved <br />March 7, 2006 <br />Type of Amount of <br />Date Transaction Transaction <br />Page 9 <br />
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