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DISCLOSURE OF INTEREST <br />If the property which is the subject of the application is owned or leased by a CORPORATION, list the principal <br />stockholders and principal officers or stockholders consist of another corporation(s), trustee(s), partnership(s) or <br />other similar entities, further disclosures shall be required which disclosures the identity of the individual(s) <br />(natural persons having the ultimate ownership interest in the aforementioned entity). <br />Sunny Isles Daycare Corp. <br />Corporation Name <br />Name, Address and Office <br />Elena Dannikova, President <br />17021 N. Bay Rd. #509, Sunny Isles Beach, FL 33160 <br />Wendy Rivas, Vice President <br />Percentage of Stock <br />80% <br />20% <br />The above is a full disclosure of all parties of interest in the application to the best of my knowledge and belief. <br />Signature:-' <br />(Applicant):�r- AIA- J)5? f7h 1 <br />Sworn to and subscribed before me, this day of its 20 '— <br />Notary Public, State of Florida at Large <br />My Commission Expir L'Y�'p No' P blio Sta e o Florida <br />Claudia C Nasbon <br />My Commission DD947457 <br />Expiras 1 211 712 01 3 <br />* Disclosure shall not be required of any entity; the equity interest is which are regularly traded on an established <br />securities market in the United States or other country; or any entity, the ownership interest of which are held in a <br />limited partnership consisting of more than 5,000 separate interest and where no one person or entity holds more <br />than a total of 5% of the ownership interest in the limited partnership. <br />City of Sunny Isles Beach Community Development Department <br />MIAMI 2911619.1 795793 6929 <br />