Laserfiche WebLink
�•-r'�'i �.nn�xrivrt <br />13ENEFICIAL INTEREST AND DISCLOSURE AFFIDAVIT <br />FLORIDA (OTHER) <br />STATE OF ) <br />INDIAN <br />COUNTY OFR����;-- <br />Before me, the undersigned authority, personally appeared ("affiant"), <br />this 22nd day of g �, )RULU who, first being duly sworn, deposes <br />and says! <br />1) That affiant is the Chairman of the Board of Commissioners of Indian <br />River County, a political subdivision of the State of Florida, as "" Seller" , <br />whose address is c/o Community Development Department, 1840 25th Street, Vero <br />Beach, Florida 32960, and in such capacity has personal knowledge of the <br />matters set forth herein and has been duly authorized by the Seller to make <br />this affidavit. That Seller is the record owner of the Property. As required <br />by Section 286.23, Florida Statutes, the following is a list of every "person" <br />(as defined in Section 2.01(3), Florida Statutes) holding 5% or more of the <br />beneficial interest in the disclosing entity: (i€ more space is needed, <br />i <br />attach separate sheet) <br />tSarne Address Interest <br />Nan -Applicable. Seller is Indian River County, a political subdivision <br />of the State of Florida <br />2) That to the hest of the affiant's knowledge, all persons who have a <br />financial interest in this real estate transaction or who have received or <br />will receive real estate commissions attornev"s or consultant's fees or anv <br />other fees or other benefits incident to the sale of the Property are:. (ii <br />non -applicable, please indicate 'None' or 'Non -Applicable') <br />Name Address Reason for Payment Amount <br />Non -applicable. <br />Page 11 <br />08/04/00 10:38AM <br />S HR.T FRM . GH <br />