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BENEFICIAL INTEREST AND DISCLOSURE AFFIDAVIT <br /> (OTHER) <br /> STATE OF <br /> COUNTY OF <br /> Before me, the undersigned authority, personally appeared LEONA DIAMOND, this Ir� day of September, 2005 , <br /> who, first being duly sworn, deposes and says : <br /> 1 ) That the LEONA DIAMOND TRUST whose address is 4301 N . Ocean Blvd. # 1001A, Boca Raton, Florida, <br /> 33431 is the record owner of the Property . The following is a list of every "person " (as defined in Section <br /> 1 . 01 (3 ), <br /> Florida Statutes) holding 5% or more of the beneficial interest in the Property : <br /> ( if more space is needed, attach separate sheet) <br /> Name Address Interest <br /> ?01 A . oo>� �1y� � gp/e <br /> : . i' ��l jam.; irk a � � ;� fl— 33 � 74o <br /> S. - <br /> 2 ) That to the best of the affiant's knowledge, all persons who have a financial interest in this real estate transaction <br /> or <br /> who have received or will receive real estate commissions, attorney's or consultant's fees or any other fees or <br /> other <br /> benefits incident to the sale of the Property are : <br /> Name Address Reason for Payment Amount <br /> 3 ) That, to the best of the affiant's knowledge, the following is a true history of all financial transactions ( including <br />any <br /> existing option or purchase Addendum in favor of affiant) concerning the Property which have taken place or will take <br /> place during the last five years prior to the conveyance of title to the LEONA DIAMOND TRUST : <br /> Name and Address Type of Amount of <br /> of Parties Involved Date Transaction Transaction <br />