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<br />STATE OF <br />COUNTY OF <br /> <br />OWNERSHIP AFFIDAVIT <br />FOR CORPORATION <br />Public Hearing No. <br /> <br />Before me, the undersigned authority, personally appeared <br />h~reinafter the Affiant (s), who being fIrst duly sworn by me, on oath, deposes and says: <br /> <br />1. Affiant is the president, vice-president or CEO of the <br /> <br />Corporation, with the following address: <br /> <br />2, The Corporation owns the property, which is the subject of the proposed hearing. <br /> <br />3. The subject property is legally described as: <br /> <br />4. Affiant is legally authorized to me this application for public hearing: <br /> <br />5. Affiant understands this affidavit is subject to the penalties of law for peIjury and the <br />possibility of voiding of any zoning granted at public hearing. <br /> <br />Witnesses: <br /> <br />Signature <br /> <br />Affiant's Signature <br /> <br />. <br />Print Name <br /> <br />Print Name <br /> <br />Signature <br /> <br />Print Name <br /> <br />Sworn to and subscribed before me on the _day of <br />AffIant is personally known to me or has produced <br />Identification, <br /> <br />,200 <br /> <br />as <br /> <br />Notary (Stamp/Seal) <br />Commission Expires: <br /> <br />City of Sunny Isles Beach <br /> <br />H <br /> <br />Planning and Zoning Department <br />