Form Fp-42b - Hotel/motel Income And Expense Report - 2003 Page 5

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N. Sale of Property or Changes in Ownership
1. Has a partial or complete interest in the real property
been sold in the last three years? (see note below)
YES
NO
Answer YES even if the transfer or conveyance is non-taxable or includes a transfer or conveyance of an economic interest in an entity that owns real
property (i.e., shares or stocks in partnerships, corporation, or trust, etc. including multi-tiered entities that own the real property). If the transference was
through an entity, the owner must complete the transfer or economic interest form. To obtain the form, call the Recorder of Deeds at (202)727-3374.
2. Nature of the Ownership (check one)
Fee Simple
Leasehold
3. Percent of Ownership
%
4. Transfer Date
5. Amount Paid for the Ownership Interest
$
6. List Annual Ground Rent, If Applicable
$
O. Ground Rent
1. Annual Ground Rent
$
2. Inception Date of Ground Lease
3. Ending Date of Ground Lease
4. Earliest Renewal Date
5. Land Area Leased in Square Feet
sq. ft.
FP-421B REV 02/2002
— CONFIDENTIAL —
Page 5 of 7

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