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NAME, ADDRESS AND OFFICE (if applicable) <br />Date of Contract: <br />If any contingency clause or contract teens involve additi <br />if a corporation, partnership or trust. <br />Percentage of Interest <br />list all individuals or officers, <br />For any changes of o ership or changes in contracts for purchase subsequent to the date of the <br />application, but r to the date of final public hearing, a supplemental disclosure of interest shall <br />be filed. <br />ivty t;ommtsston rxpires: �—� <br />* Disclosure shall not be required of any entity; the equity interest is which are regularly traded on <br />an established securities market in the United States or other country; or any entity, the ownership <br />interest of which are held in a limited partnership consisting of more than 5,000 separate interest <br />and where no one person or entity holds more than a total of 5% of the ownership interest in the <br />limited partnership. <br />Public Hearing No: <br />City of Sunny Isles Beach Public Hearing Application Package <br />Page 16 of 30 <br />28 <br />