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O'WNER'S AFFIDAVIT NON -FOREIGN CERTIFICATE AND REQUEST FOR TAXPAYER IDENTIFICATION NUMBER STATE OF FLORIDA COUNTY OF INDIAN RIVER BEFORE ME, the undersigned authority, personally appeared Karen S. Beck, a married woman, (the "Seller"), ("Seller" refers to singular or plural as context requires) who, first being duly sworn, deposes and says: A. OWNER'S AFFIDAVIT Seller is the owner of the following described property (the "Property"): SEE EXHiBiT "A" ATTACHED HERETO AND MADE APART HEREOF Property Adthess: 7580 66th Avenue, Veto Beach, FL 32966 2. There is no outstanding contract for the sale of the Property to any person or persons whomsoever, nor any unrecorded deed, mortgage or other conveyances affecting the title to the Property. 3. There are no liens, encumbrances, mortgages, claims, boundary line or other disputes, demands or security interests in, on or against the Property or any goods, furnishings, appliances, fixtures or equipment now installed in or which are to be affixed to the Property; except for mortgages described in the deed given by the undersigned; that there are no unpaid taxes, levies, assessments, paving liens or utility liens against the Property (other than real estate taxes for the current year). 4. That there have been no improvements upon the Property within the past ninety (90) days for which there remain any outstanding and unpaid bills for labor, materials or other charges for which a lien or 'liens might be claimed by anyone whomsoever. 5. That there are no matters pertaining to the Seller which could give rise to a lien that would encumber the Property during the period of time between the effective date of the Title Insurance Commitment and the time of recording of the Warranty Deed and that the Seller has not executed and will not execute any instrument that would adversely affect the title to the Property from the date of the Affidavit forward. 6. That there are no judgments, claims, disputes, demands or other matters pending against Seller that would attach to the Property. Seller has complied with the Florida Sales Tax laws where applicable. Seller acknowledges responsibility for water, sewer and electrical consumption charges through date of closing or occupancy by Buyer, whichever first occurs. 7. Seller is in sole constructive or actual possession of the Property and no other person has any right to possession of the Property, or asserts any claim of title or other interests in it. 8. Seller represents that there are no violations of governmental laws, regulations or ordinances pertaining to the use of the Property. B. NON -FOREIGN CERTIFICATE AND REQUEST FOR TAXPAYER IDENTIFICATION NUMBER Section 1445 of the Internal Revenue Code provides that a Transferee ("Buyer") of a U.S. real property interest must withhold tax at a rate of 10% of the amount realized on the disposition if the Transferor ("Seller") is a foreign person. To inform the Buyer that withholding of tax is not required upon the disposition of a U.S. real property interest by the Seller, the undersigned hereby swears, affirms and certify(ies) the following as or on behalf of the Seller: 1. Sellers' Legal Name is: Karen S. Beck. 2. Sellers Home Address or Office Address if Corporation, Partnership or Trust: 7580 66th Avenue, Vero Beach, FL 32966 File No: 48083683 Pagc I of 3 LW