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<br />mSCLOSURE OF INTEREST <br /> <br />If the property which is the subject of the application is owned or leased by a <br />CORPORA TION, list the principal stockholders and principal officers or stockholders <br />consist of another corporation (s), trustee (s), partnership (s) or other similar entities, <br />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 /> <br />Ocean Palm Motel, Inc. <br />Corporation Name <br /> <br />Name. Address and Office <br /> <br />. \ Vl',.1'\ R. S,h-", LV+e (1"14'1 <br />r~o;,;~t' <br />_151'1 $"" G..H lnS ~. <br />S" \.1>\""'" \ .s.}.p s) 8 <br />T 33){,/l <br /> <br />Percentage of Stock <br />\ ~07~ <br /> <br />If the property, which is the subject of the application, is owned or leased by a <br />TRUSTEE, list the beneficiaries of the trust and the percentage ofinterest held by each. <br />{Note: where the beneficiary (s) consist of corporation (s), another trust (s), partnership <br />(s) or other similar entities, further disclosure shall be required which disclosures the <br />identity of the individual (s), (natural persons) having the ultimate ownership interest in <br />the aforementioned entity} . <br /> <br />Trust Name <br /> <br />Name and Address <br /> <br />Percentage of Interest <br /> <br />,.~; -.. .,",""-: :",:;-.:: -.r:~-~~"" ',"::' :::,':' <br /> <br />.. . ..,..- -,. ~ . <br />.~ _... .. -.. <br /> <br />"':::'";;":"';"-"";;'.7':<;;'::<:'::-..';-".,-.:,,:::-,-:0-.7;-':-'::':';":'"'r"',."::..~.~::,..;:",,. . <br /> <br />City of Sunny Isles Beach <br /> <br />Planning and Zoning Department <br />