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Allan T. Shulman/Ocean-Fairwind LLC S IZ. iII. I~. UZSC~.pSURE pr` °ERMS At'~tiJ Af~rpt9Ca~'S pF d.pE3F~YIST COT-".F?Et~SATTpIY (t3Z$CI,pSE b~i-i s i''„"r~; h't?i F~ 7' X.4 ~ OCi OFXEfI,j. „ ;` .. .,~ Q ~ O J a~ ~ OMOU u. V "~ ci cw O ,.~ Q N ~v w +-' ~ ~ ¢~ ~ ~ r ~ ,o v N ~ .. ^[ ;~ ~ ai W ~ `" 4 lY~1 ' ~ CJ W .~ ~ ~ .J H -~ O "- Z ° c: V. $TG~dA'i'TSStE UNDER pAEfi: OtV OC7`tJLiER 1sr C3E EA~t-~ YEA2, EACi~i LQE3E3YI SHALL StSSi~fI'i 7Ca' 7~fE C.~"~' C:Lc42K,.~ r3=3`sED STATENTENT UNDER i1A~3•i, LI53I~3G Lt3~E3YIi`tG £XPENDITt~RES, AS V'lELL A5 ... ?•,?'~NSL.?~vnC3 F2ECEIUELt, IN fiNi_ CI't"Y C3E ~3IAMI EiEAGt EC.)R ~h€E Pr~ECEDIN~ CALi:NDAR YFA~c. A S"F'ATEP~SEI~ s S}-6A?..L EiE FILED EVEN I3= `4"~{ERE HAVE SS=EtV I~IO EXPE?4't7I7tfRES a'~R CC}s°U'rPEtdSA"~"`°t (7UC2INC~ TeE R:'.e~`~R:"iNG RERIt7I3. a,nub:tE _: ~GLl;ye~ ~~ _~..w_~ i Cj~7 SOPf"t'?'i;y 54'dc'u'r ~~s~t 3!! pf `t~t~ fpr~e70ir~ t3C.T~ ~t'? true cr•G C~rre_; ~~L %}2c3#~ ,~ ";2Ve r°u~C»' ~. c~iTl f~rrti!iar a,.?Yh C'7e prc~visiorb5 cCr<taine~ in Section 1-~r$~ of Che t~1iami be~v~ Ci?y° t~:,de ~:~°i ~! , F ~,~7rtinc~ requirem~ ris, ~/~-,,, y/ - ' - f Yes a; A__,_ re yoe~ !~?bb~isa~ an ~ aresent o,!„pe_raciinq bid fcr +u3oo~s~„ec~uipr~ient,oe ~;~ r ..: , or a~ a - >~,resenti as per~dr~ar~ ~+~at~rd for meads e ui rnenf car service? 2 , t;rsv~r^t to ~1,.=r~; F,t~ach City Code 2-~~~ Entw'rti~ .,~,ohit~ite~ Gr";~~i~r~ uor}tr3'?.:ti~ns Br _a'_;:ayi~ts ~~n fZea ' Stw%~ Cep°iuL~ti':?rr: ISSta~S"'. ~`tg~~oc_W~re..~+c~: Pobby"¢r~ can ~ Pe^~'•nro_?~~Iicatian for a t7euefaras7aenf A red=i~erl_a! ?~tf~.::_Ci~or a,~ ~ti~_f~r cha_~rge of zQnine~m~~cgnat .o_.~c or chance ta.,}t~e,~it~ a`~s_-e L~ ^s~ ~jse j'~ 'ur5Udnt trJ i''rldCili ~C^dCh C~tv t,Cs{f? ~-~-~~ (ti~ t+n'y p~=`5C7ri ~L'X~t,,~t t!lOSC'. E:,Xd(7t:~t ~:Cst.= ire aQ~2(tifltl (3` i "loizbyist" es set `ooh ,. S~C~i(.3I1 Z-i52 ~bGVr1 ~~.^0 ;r~i'y ~~f.p~ars ~s ~ reprF_e~..F~r: :` ~ r,G~-`ar-arafit CJ."~?G~r~tiC3f1 (3r GCitix;! ~~V!thrJitt SrE:?rle~i CO?13~C'n5r.~pr' fr r,,;ei'.hUfSP.~4~'flt f(} 7.,E<'. ~j?~t'u"~itl..C, .'t`i:*':. ' G''srE°w':, Gr rp~ir~;ct, to express su,~part G` or opp;~5=tion rp any item, s',a regat~t "~o;t^ the ciak as re~,sireu ~y the s;zction ~u~, SE~~(` r;a• be req.:,re~ ko pay ~ny~ reyist'at:c~n `ces.. . Yes Are Yata r~tareser7t"snq <'3 nat-far-~pra~t carpar-tt'?o~ tir t~ntity +~•i~fsot_._._s~recg _ .,~t?rnpCns~"aan ar reirrsbtsrse+'rte~Y. ,~cr~•<ur~ cr rrnctpa ,~ ten:,. ____.. -w..~_~~ ~..., 1rI. Gp8BYZ5TIl7EI~TI#°~~A?~'pJY: PR?NCPA! .DENTZfZCC ,, Pro~~eed Tt? r; ?roduce~ ID ______~. Far;n of ?~enti~c~tian ; rrrr. , p~rs~nagy" kno~r~n (Lcabbst) ::~ Persan~!"y+ knowm {F'ri VII. SIG?~A~'URE A€VA STA3~SP OF S~t~~'ARY; .. __ '~';t5 ._.~'~ay 'Jf " ^.c OCEAN-FAIRWIND LLC DISCLOSURE OF INTEREST Member Name, Address & Office Oceanside Resorts, Inc. 605 Lincoln Road, #320 Miami Beach, FL 33139 Disclosure of Interest for Oceanside Resorts, Inc. Name. Address & Office David Callen 8870 North Himes Avenue, #242 Tampa, Florida 33614 Robinson Callen Trust A PO Box 403367 Miami Beach, Florida 33140 Beneficiaries: Claire Callen c/o Oceanside Resorts Inc 605 Lincoln Rd, #320 Miami Beach, FL 33139 Lana Callen 865 North Shore Drive Miami Beach, FL 33141 Robin Callen 1507 West River Lane Tampa, FL 33603 Casper R. Callen Trust 618 East Broughton Savannah, GA 31401 Beneficiaries: Andre Callen c/o HI Development Corp. 1 1 1 West Fortune Street Tampa, FL 33602 Sean Callen c/o HI Development PR 1004 RH Todd Avenue, 3'd FL San Juan, PR 00907 Ian Callen c/o HI Development Corp. 1004 RH Todd Avenue, San Juan, PR 00907 Dorian Callen PO Box 2669 Winter Haven, FL 33880 Desiree Callen O'Neill 425 Lake Ned Road Winter Haven, FL 33884 of Ownership 100% of Ownership 8% 46% 33.3% 33.3% 33.3% 46% 14.29% 14.29% 14.29% 14.29% 14.29% Tarquin Callen 14.29% c/o Callen Trust PO Box 8747 Savannah, GA 31412 Justine Callen Bohannon 14.29% P O Box 7142 Winter Haven, FL 33883