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STATE OF_ <br />COUNTY OF. <br />OWNERSHIP AFFIDAVIT <br />FOR CORPORATION <br />Public Hearing No. <br />Before me, the undersigned authority, personally appeared Eric Fordin <br />hereinafter the Affiant (s), who being first duly sworn by me, on oath, deposes and says: <br />1. Affiant is the authorized representative president, vice-president or CEO of the <br />MB RE Investments, LLc Corporation, with the following address: <br />2. The Corporation owns the property, which is the subject of the proposed hearing. <br />3. The subject property is legally described as: <br />See attached Exhibit A <br />4. Affiant is legally authorized to file this application for public hearing: <br />5. Affuant understands this affidavit is subject to the penalties of law for perjury and the <br />possibility of voiding of any zoning granted at public hearing. <br />6. Affiant understands that the matters attached to and made part of the application are <br />honest and true to the best of my knowledge and belief. I understand this application must <br />be complete and accurate before the application can be submitted and the hearing <br />advertized. <br />1h _ I.: T.a - . <br />a to <br />t Name <br />Signature <br />Print Name <br />Sworn to and subscribed before me on the day of <br />Affiant is personally known to me or has produced _ <br />Identification. <br />Commission Expires: <br />Ypv •.. SHILAMNIEVES <br />`: Notary Public State of Florida <br />Commission # HH 288903 <br />M Comm. E�i fires Juf 17, 2016 <br />oFF. Y P <br />Bonded through National Notary Assn. <br />City of Sunny Isles Beach <br />Public Hearing Application Package <br />��" q"'e' <br />Affiant's Signature <br />-45flG b✓t V1 <br />Print Name <br />Notary <br />20,Qg, <br />Page 9 of 23 <br />72 <br />