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Exhibit B . Disclosure of Relationships <br /> THIS FORM MUST BE SIGNED IN THE PRESENCE OF A NOTARY PUBLIC <br /> OR OTHER OFFICER AUTHORIZED TO ADMINISTER OATHS . <br /> This sworn statement is submitted with that certain Agreement for Donation of Surplus County . <br /> Owned Lands . <br /> 1 . This sworn statement is submitted by : S � ` V C l L 2 . <br /> ( N of ntit submitting sworn statement) <br /> whose business address is : <br /> 0 Rn 1-- and <br /> ( if applicable ) its Federal Employer Identificat <br /> ion Number ( F IN ) is � - <br /> 2 . My name is ✓I Vim-- ` 1 <br /> ( Please print name of i dividual signing ) I <br /> and my relationship to the entity named above is T <br /> 3 . 1 understand that an " affiliate " as defined in Section 105 . 08 , Indian River County Code , <br /> means . <br /> The term "affiliate " includes those officers, directors, executives, partners, <br /> shareholders, employees, members, and agents who are active in the management <br /> of the entity. <br /> 4 . 1 understand that the relationship with a County Commissioner or County employee that <br /> must be disclosed is as follows : <br /> Father, mother, son, daughter, brother, sister, uncle, aunt, first <br /> cousin, nephew, niece, husband, wife, father-in-law, mother-in- <br /> law, daughter-in-law, son-in-law, brother-in-law, sister-in-law, <br /> stepfather, stepmother, stepson, stepdaughter, stepbrother, <br /> stepsister, half brother, half sister, grandparent or grandchild. <br /> 5 . Based on information and belief, the statement which I have marked below is true in <br /> relation to the entity submitting this sworn statement . [ Please indicate which statement <br /> applies . ] <br /> gecu <br /> Neither the entity submitting this sworn statement , nor any officers , directors , <br /> tives , partners , shareholders , employees , members , or agents who are active in <br /> management of the entity , have any relationships as defined in Section 105 . 08 , Indian <br /> River County Code , with any County Commissioner or County employee . <br /> The entity submitting this sworn statement , or one or more of the officers , directors , <br /> executives , partners , shareholders , employees , members , or agents who are active <br /> in management of the entity have the following relationships with a County <br /> Commissioner or County employee : <br />