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•• <br />40 <br />L <br />ADDENDUM <br />BENEFICIAL INTEREST AND DISCLOSURE AFFIDAVIT <br />(OTHER) <br />STATE OF FLORIDA <br />COUNTY OF DADE <br />Before me, the undersigned authority, personally appeared <br />Annette R. Roberts 'this 25th day of <br />June 1999, who, first being duly sworn, deposes and says: <br />Annette R. Roberts <br />That whose address is <br />255 W 51st Street Hialeah, FL 33012is 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 bene`icial interest in the Property: <br />(if more space is needed attach a separate sheet) <br />Name Address <br />100% Interest <br />Annette R. Roberts <br />255 W. 51st Street <br />Hialeah, FL 33012 <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 <br />John H. Test, P.A. 9400 S. Dadeland Blvd undetermined amount legal fees <br />Ste. 300, Miami, FL 33156 <br />Lambert Commercial Real Estate, Inc Realtor Commision 8% <br />1902 14th Ave. Vero Beach, FL 32960 <br />Eric Barkett, Esq. 2165 15th Ave. undetermined legal fees <br />Vero Beach, FL 32960 <br />That, to the best of the affiant's knowledge, the following is a true history of all financial <br />transactions (including any exieting 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 Indian River County, FL <br />L <br />