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<br />06-15-2006 09:22AM <br /> <br />FROM- <br /> <br />T-444 P,OlO/015 F-G75 <br /> <br />"-./ <br /> <br />DISCLOSURE OF INTEREST <br /> <br />If rhe propel'ly which is the subject of the upplication is owned or leased by a CORPORATION, list the principal <br />stoCkholders and principal oJ'licers or slockholders consist of another corp01"ltion(s), trustee(s), partncrship(s) 01' <br />orher similar entities, fiJrrher disclosures shan be required which disclosures the ide1Jlity the individual (s) (nntural <br />persons h.ving the ultimate ownership' Interest in the aforementioned entity) <br /> <br />Ocean Palm Development, LLC, a Florid. limited liability company <br /> <br />Name Address anti Omee Percent..c on;tock <br />,...... <br />Bmce Goldstein, Member 100% <br />1 <br /> <br />If the properry, wluch is the sul:\lect of lbe UpphCallon, 15 owned or leased by a TRUSTEE, list rhe beneficlar,es of <br />lhe Imst .md the percentnge of interest held by each. {Note: where the beneficiary(s) consist of cOlporutions(s), <br />another mlst(S), paI1nership(s) or other similar entities, funher disclosure shall be required which disclosures the <br />identity of the individual(s), (natural persons) having the ullimate ownership intere.t in lhe aforementioned entity), <br /> <br />NOT APPLICABLE <br />Trost Name ' <br /> <br />Name and Address <br /> <br />l'ercenta~e oflmeresl <br />