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rt ' <br /> take place during the last five years prior to the conveyance of title to the State of Florida: (if non-applicable, <br /> please indicate "None" or "Non-Applicable") <br /> Name and Address Type of Amount of <br /> of Parties Involved Date Transaction Transaction <br /> / vUN 'r <br /> This affidavit is given in compliance with the provisions of Sections 286 .23 , 375 . 031 ( 1 ), and 380.08(2), <br /> Florida Statutes. <br /> AND FURTHER AFFIANT SAYETH NOT. AFFIA <br /> STATE OF ;/IP 1414C ) <br /> COUNTY OFT44tZ t <br /> SWORN TO and subscribed before me this '^{� day of 200 , by <br /> Such person(s) (Notary Public must check applicable box): <br /> is/are personally known to me. <br /> [ ] produced a current driver license(s). <br /> [ ] produced as identification . <br /> (NOTARY PUBLIC SEAL) <br /> *taublic <br /> REM <br /> TTHEW auosans� (Printed, Typed or Stamped Name of <br /> nn. zouNotary Public) <br /> wl Assn Cu_ Commission No. : <br /> My Commission Expires : <br /> BLA- 133 REVISED 5/9/02 <br />