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Foreign Entity Ownership Affidavit <br /> (required with every bid or offer, or contract which gives Entity access to an <br /> individual's personal identifying information) <br /> The undersigned,on behalf of the Entity listed below,hereby attests under penalty of perjury as <br /> follows: <br /> 1. Entity is not owned by the government of a foreign country of concern as defined <br /> in Section 287.138,Florida Statutes. (Source: § 287.138(2)(a),Florida Statutes) <br /> 2. The government of a foreign country of concern does not have a controlling <br /> interest in Entity. (Source: §287.138(2)(b),Florida Statutes) <br /> 3. Entity is not organized under the laws of,and does not have a principal place of <br /> business in,a foreign country of concern. (Source: § 287.138(2)(c),Florida <br /> Statutes) <br /> 4. Entity is not owned or controlled by the government of a foreign country of <br /> concern,as defined in Section 692.201,Florida Statutes. (Source: § 288.007(2), <br /> Florida Statutes) <br /> 5. Entity is not a partnership,association,corporation,organization,or other <br /> combination of persons organized under the laws of or having its principal place <br /> of business in a foreign country of concern,as defined in Section 692.201, <br /> Florida Statutes,or a subsidiary of such entity. (Source: § 288.007(2),Florida <br /> Statutes) <br /> 6. Entity is not a foreign principal,as defined in Section 692.201,Florida Statutes. <br /> (Source: §692.202(5)(a)(1),Florida Statutes) <br /> 7. Entity is in compliance with all applicable requirements of Sections 692.202, <br /> 692.203,and 692.204,Florida Statutes. <br /> 8. (Only applicable if purchasing real property)Entity is not a foreign principal <br /> prohibited from purchasing the subject real property.Entity is either(a)not a <br /> person or entity described in Section 692.204(1)(a),Florida Statutes,or(b) <br /> authorized under Section 692.204(2),Florida Statutes,to purchase the subject <br /> property.Entity is in compliance with the requirements of Section 692.204, <br /> Florida Statutes. (Source: §§692.203(6)(a),692.204(6)(a),Florida Statutes) <br /> 9. The undersigned is authorized to execute this affidavit on behalf of Entity. <br /> orViet44414-sie <br /> Si are <br /> Y r? <br /> Printed Name n <br /> �CF / S/Deil/T <br /> Title <br /> PP /MAC 134/W_ <br /> Entity <br /> Date: DG <br /> "'/z—o2 <br />