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EXHIBIT "D" <br />BENEFICIAL DISCLOSURE AFFIDAVIT <br />DISCLOSURE STATEMENT <br />(INDIVIDUAL) <br />The following Disclosure Statement is given in compliance with Sections 375.031(1) and 380.08(2), <br />Florida Statutes. The Seller states as follows: <br />1) That to the best of the Seller's knowledge, all persons who have a financial interest in this <br />real estate transaction or who have received or will receive real estate commissions, attorneys or <br />consultant's fees or any other fees or other benefits incident to the sale of the Property are: <br />Name Address Reason for Payment Amount <br />2) That to the best of the Seller's knowledge, the following is a true history of all financial <br />transactions (including any existing option or purchase agreement in favor of Seller) concerning the <br />Property which have taken place or will take place during the last five years prior to the conveyance <br />of title to the State of Florida: <br />Name and Address Type of Amount of <br />of Parties Involved Date Transaction Transaction <br />SELLER <br />