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A <br />ADDENDUM <br />BENEFICIAL INTEREST AND DISCLOSURE AFFIDAVIT <br />(OTHER) <br />STATE OF FLORIDA /� <br />COUNTY OF R45 `� CAO <br />O U <br />Befor e, a undersigned authority, personally appeared <br />, el ' �,-. - � -� this r (o day of <br />r u cx 1999, who, first being duly sworn, deposes and says: <br />That A►�� (tom- �'� whose address is <br />,5 L � C &:::L,-"33�1a is the record <br />owner of the Property. The following is a list of every person (as defined up Section <br />1.01(3), Florida Statutes) holding 5% or more of the beneficial interest in the Property: <br />(if more space is needed attach a separate sheet) <br />Name Address <br />It,CGelninterest <br />AnV1CA-k-t- , I1 1S t vjj V C <br />S I S tY e <br />That to the best of the affiant's knowledge, all persons who have a financial interest in <br />this real estate transaction of who have received or will receive real estate <br />commissioners, attorney's of 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 <br />Amount tnA Yu.eCAr rt l�, <br />r N ,lest- GA <br />i 1 VJ <br />.�)e.: C+.Ao��Z`>�c -T- -n.C, . <br />kl <br />That, to the best of the affiant's knowledge, the Following is a true history ofal financial <br />transactions (including any existing option or purchase agreement in favor of affiant) <br />concerning the Property which have taken place or will take place during the last five <br />years prior to the conveyance of title to ►3 <br />