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1999-142
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1999-142
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ADDENDUM <br />BENEFICIAL INTEREST AND DISCLOSURE AFFIDAVIT <br />(OTHER) <br />STATE OF FLORIDA <br />COUNTY OF INDIAN RIVER <br />Before me, the undersigned authority, personally appeared <br />, this day of <br />.1994, who, first being duly sworn„ deposes and says: <br />That whose address is <br />is the record <br />owner of the Property. The following is a list of every "person" (as defined in 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 />Interest <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 Beason for Payment <br />Amount <br />That, to the best of the affiant's knowledge, the following is a true history of all 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 <br />a <br />
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