saie t date: t-r l l from lease · 2020-02-19 · 24701 us hwv 19 north clearwater, fl 33763 phone:...

14
ROTHMOOR ESTATES CONDOMINIUM ASSOCIATION, INC. 405 Cara Court, Largo, FLI}TTL 55+ Community APPLICATION DATE UNIT # APPLICATION FOR PROPOSED SAIE T PROPOSED CLOSING DATE: t-r Lease l_l From to (3 Month Minimum) APPLICANT #1 PHONE CELL APPLICANT #2 PHONE CELL CHECKLIST THE FOLLOWING ITEMS ARE NEEDED TEN (101 DAVS pRtOR TO A FORMAL |NTERV|EWAPPROVAL FOR THE PURCHASE OF A CONDOMINIUM. MISSING OR INCOMPLETE INFORMATION WILL CAUSE THE APPLICATION TO BE RETURNED WITHOUT ACTION. COMPLETED APPLICATION MAY BE MAILED/FAXED OR EMAILED MAIL ORIGINALS WITH CHECK TO: Ameri-Tech Companies. lnc. 24701 US Hwv 19 North Clearwater, FL 33763 Phone: 727 726-8OOO Fax: 727 723-tLOt Email Application to: [email protected] Page 1 of 3 _Application fee $100 (pay to ROTHMOOR ESTATES) Completed application _Color copy of driver license (each applicant) _A copy of sales contract or lease _Background form with signatures of applicant(s) Affidavit for transfer of ownership (Sale) Certificate for tenant approval (Lease) Completed 55+ age verification page Com pleted Voting Certificate (Sale) Signed rules acknowledgement page Completed One Call Sheet Completed Emergency Contact Information

Upload: others

Post on 18-Jul-2020

0 views

Category:

Documents


0 download

TRANSCRIPT

Page 1: SAIE T DATE: t-r l l From Lease · 2020-02-19 · 24701 US Hwv 19 North Clearwater, FL 33763 Phone: 727 726-8OOO Fax: 727 723-tLOt Email Application to: GReed@ameritechmail.com Page

ROTHMOOR ESTATES CONDOMINIUM ASSOCIATION, INC.

405 Cara Court, Largo, FLI}TTL55+ Community

APPLICATION DATE UNIT #

APPLICATION FOR PROPOSED SAIE T PROPOSED CLOSING DATE:

t-rLease l_l From to (3 Month Minimum)

APPLICANT #1

PHONE CELL

APPLICANT #2

PHONE CELL

CHECKLIST

THE FOLLOWING ITEMS ARE NEEDED TEN (101 DAVS pRtOR TO A FORMAL |NTERV|EWAPPROVAL FOR

THE PURCHASE OF A CONDOMINIUM. MISSING OR INCOMPLETE INFORMATION WILL CAUSE THEAPPLICATION TO BE RETURNED WITHOUT ACTION.

COMPLETED APPLICATION MAY BE MAILED/FAXED OR EMAILED

MAIL ORIGINALS WITH CHECK TO:

Ameri-Tech Companies. lnc.24701 US Hwv 19 North

Clearwater, FL 33763

Phone: 727 726-8OOO Fax: 727 723-tLOtEmail Application to: [email protected]

Page 1 of 3

_Application fee $100 (pay to ROTHMOOR ESTATES)

Completed application

_Color copy of driver license (each applicant)_A copy of sales contract or lease

_Background form with signatures of applicant(s)Affidavit for transfer of ownership (Sale)

Certificate for tenant approval (Lease)

Completed 55+ age verification page

Com pleted Voting Certificate (Sale)

Signed rules acknowledgement page

Completed One Call SheetCompleted Emergency Contact Information

Page 2: SAIE T DATE: t-r l l From Lease · 2020-02-19 · 24701 US Hwv 19 North Clearwater, FL 33763 Phone: 727 726-8OOO Fax: 727 723-tLOt Email Application to: GReed@ameritechmail.com Page

Applicant #1

Phone #

ROTHMOOR ESTATES CONDOMINIUM ASSOCIATION, INC.

405 Cara Court, Largo, FL3377t55+ Community

Email

Cell#

Social Security #

Email

Cell#

Date of Birth Age

Applicant #2

Phone #

Date of Birth Social Security #

lf you are purchasing this unit for your own housing or as personal housing for a family member,indicate the names, ages and vehicles of those who will regularly occupy the unit. (Note: A newlypurchased unit may NOT be leased until owned for l year)

Age

Name Age

Name

VEHICLES

Vehicle Make

Vehicle Make

Model Color Year_State Tag #

Model_Color Year State Tag #

EMERGENCY CONTACT

Name Phone #

Name Phone #

APPLICANT ACKNOWTEDGEMENT OF RECETpT OF THE ASSOCTATTON DOCUMENTS (SALE ONLy)Before you complete and sign this form, the seller is responsible for providing you, at no cost to you, a copy of thefollowing documents. Have you received these documents? (soon to be available online)

a. The Declaration of Condominium with all amendments? yes

b. Articles of Incorporation with all amendments? yes

c. Bylaws with allamendments? yes

I understand that I am responsible for the contents of the above documents and that I will be held to comply

with all of the provisions therein notwithstanding any contrary oral representations. m Initial

Page 2 of 3

No

No

No

Page 3: SAIE T DATE: t-r l l From Lease · 2020-02-19 · 24701 US Hwv 19 North Clearwater, FL 33763 Phone: 727 726-8OOO Fax: 727 723-tLOt Email Application to: GReed@ameritechmail.com Page

APPLICANT INTERVIEW

Once all paper work as listed on page L has been received, an interview is required for sales and leases.

Please indicate times and days that you are available for the face to face interview.

Times: vron I ruesE wed E rhurs [l rti[lAFFIDAVIT FOR TRANSFER OF OWNERSHIP {SALE ONLYI

Upon completing the interview successfully, you will be given the notarized "Affidavit for Transfer ofOwnership" which you must bring to your closing.

APPLICANT ATTESTATION AN D SIGNATU RE

l/we hereby authorize the Association to do a background check, including credit history and criminalbackground check. The results of the background check shall remain confidential.

APPLTCANT(S) STGNATURE(S)

Signature: DatePrinted Name:

Signature: Date:Printed Name:

Revised 2079.L2,09 Page 3 of 3

Page 4: SAIE T DATE: t-r l l From Lease · 2020-02-19 · 24701 US Hwv 19 North Clearwater, FL 33763 Phone: 727 726-8OOO Fax: 727 723-tLOt Email Application to: GReed@ameritechmail.com Page

CUSTOMER NUMBER 2325 . AMERI{ECH

PROPERTY i ASSOCIATION ROTHMOOR [STATIS

DATE:

I/We I pr0spective

tenant(s) / buyet(s) for the property located at

Managed By: OwnedBy;1{+rbyrllowT$N/rNTCIIECKaudor1hcprop*ttyov/r|qf/manBgettolnq*ircintorty/ourorcdittilc,orimino[androualhitlcryaslvell{00!|Blttinfonrrttioriforusa|nprfxllng0ftfig*ppl|*ltlcrt.l/wcunrisktstlJrtlnt6nmy/ourc,oaitnt.it''inappcarrho.1.0AN?I / we cannot claltn eny invesion of privacy or any othcr clolrn thflt mfly ariso agEiflst TENAT.II CHBCK nory or in the fircuIs,

TLEASE PBI.NT CLEARLY

INSOnM,AIIoNt $FaUS$J.ege!4!44TEi"

$!NoLE_ MARRIED $IhISLF'-* MARRIED

FULL NAIT,IE: EUI,LNAMST

DATEggBtsIgi_* DArEoFgsT&

DRTV4RTICENSE#i ., . .*. oRrvElrilc}jggF#r

CLIRRFNT il)PnE$sr _ cV.SfSN?ApElt{ESi

gowt0N6t HOWLOt'lG?

{,4$DtOnD.&PllO}fBr . *_ g.ANpr0t}D&fgqiitEr

lgE!fioug.d$t]Rss$; PREVIQ{{$A.D.Dfi,[$sr _HOW LONS? trowLoN6?

EMIIL,oY!Br EMPLOYBR:

o€euPATIoNr-.*-=--, _.. _,-.-.-.------*_ occltlATroN:

'snoss MoNTr&y rNcgM.E: _- gglsg-MSNTHLy-nrcoMEj*

leNar@ w- _ _WOR(fHONENUMBERT ._ _ WQLKP$ONg.i.{$MS$Rr

TIAVE YOU EVER BEEN ARRESTED? HAVB VOU EYSR BBEN ARRESTED?(clRcLEoNE) yES NO (CIRCLEONB) yES NO

HAYE YOU EVER BEEN EVICTED? T{AVE YOU EVER BEEN EVTCTED?(crRcLE oNEl yEs No (CIRCLAONE) yES NO

SIGNATURE: STGNATUREI

PHONE I.I{JM$ER;PHONEMJMBBR:

TENANT CI{ECK HOURS OF OPERATION:MONDAY - FRIDAY r 9100 s.m, - 5:30 p.m,

SATURDAY I 11:00 n.m. - 4100p.m.ALL ORPERS IieCglVEO AfIBR f:00 p,[\ (]:l0f,A! on Srt.]r#tLL Bg PROCSSScD Tllg

NEXT DUSINESS DAY

TENANT CHECK FAX #r Q21r 942-6843

IF TgE WRONC SOCTAL SECURITY NUMEER tg SUilldlrTED, ASOCOND APPIICATION rEE WILL BE CHARGED To RI/PULL THE

RETORT.

REALTORS / PROBERTV MANAAERS I ATARTMBNT COMIJLEXES /

TEDERJTL LAW REQUIREe THS 8ND IrSPR TO iltAlNfAlN TUIg loRlyl FOR A fgru0D OItGtl€, VE{RS ltotr!nt ch(rk rplllcallon roy,08/1008)

Page 5: SAIE T DATE: t-r l l From Lease · 2020-02-19 · 24701 US Hwv 19 North Clearwater, FL 33763 Phone: 727 726-8OOO Fax: 727 723-tLOt Email Application to: GReed@ameritechmail.com Page

Rothmoor Estates Condominium Association, Inc.

STATE OF FLORTDA )

couNTY oF PTNELLAS ) SS

Personally appeared before me, the undersigned authority,

Who, after being duly sworn, depose and says:

AFFIDAVIT FOR TRANSFER OF OWNERSHIP

Director

That he/she is an officer of Rothmoor Estates Condominium, Inc., a Florida not for Profit Corporation:that at a meeting of the Unit-Owner Committee of Rothmoor Estates Condominium, Inc. held on the

_day of 2O_, the application offor approval of their acquisition of Condominium #

was duly considered: that upon a vote of the members of the Unit-Owner Committee, in accordancewith the provisions of the By-Laws of the corporation, the said transfer to

was approved.

Director Signature

This foregoing instrument was acknowledged before me on this_day of _,20_by who is personally known to me_ or, whohas produced a valid driver's license as identification

NOTARY PU BLIC SIG NATU RE

Commission Expires

Revised 20t9.t2.O9

Page 6: SAIE T DATE: t-r l l From Lease · 2020-02-19 · 24701 US Hwv 19 North Clearwater, FL 33763 Phone: 727 726-8OOO Fax: 727 723-tLOt Email Application to: GReed@ameritechmail.com Page

ROTHMOOR ESTATES CONDOMINIUM ASSOCIATION, INC.

405 Cara Court, Largo, FL3377L

CERTIFICATE FOR TENANT APPROVAL

LEASE DATE FROM TO

This Certificate will serve as approval for the LEASE of the unit at:

Address

From: Owner Phone #

Address

To: Tenant Phone #

The Tenant Owner Committee has reviewed this proposal and has acted favorably on behalfof the transaction.

On Behalf of Rothmoor Estates Condominium Association, Inc.,

Date:

By:

Title

Revised 2OI9.L2.O9

Page 7: SAIE T DATE: t-r l l From Lease · 2020-02-19 · 24701 US Hwv 19 North Clearwater, FL 33763 Phone: 727 726-8OOO Fax: 727 723-tLOt Email Application to: GReed@ameritechmail.com Page

ROTHMOOR ESTATES CONDOMINIUM ASSOCIATION, INC.

405 Cara Court, Largo, FL3g77l.

55+ Community

OVER 55 FORM

The Provisions of the Fair Housing Amendments Act require that each over fifty five community mustconduct a cen'sus of all occupants in each unit. Please answerthe following questions.

Name Owner/Tenant

Date of Birth

Name Owner/Tenant

Date of Birth

STREET ADDRESS

CITY STATE

t Bedroom fl z bedroom E ro*nhouse

Date occupants first began/will begin to reside in the dwelling:

To establish our position as an over 55+ sernrnLtnity, we must have on file a survey indicatingthe ages of alloccupants residing in Rothmoor Estates. Proof can be a copy of any document showing date of birth suchas: Birth Certificate, Driver License, State ldentification Card, Voter's Registration Card, etc.

ztP

Signature - Owner/Tenant

Document ProvidedDate

Witness Date

Signature - Owner/Tenant Date

Document Provided

Witness Date

Revised: 20t9.72.09

Page 8: SAIE T DATE: t-r l l From Lease · 2020-02-19 · 24701 US Hwv 19 North Clearwater, FL 33763 Phone: 727 726-8OOO Fax: 727 723-tLOt Email Application to: GReed@ameritechmail.com Page

VOTING CERTIFICATE

Rothmoor Estates Condominium Association, Inc.405 Cara Court, Largo, FL33771.

Wetheundersigned,beinga||oftheoWnersofunit#-,doherebycertifythatthefol|owingnamed one of us is the authorized voter for the forgoing unit, and shall remain such designated voter untilthis certificate is revoked by subsequent certificate:

Name of authorized voter

Date this for completed

Please select the signature category below which describes your form of ownership and sign in theappropriate places:

tf We are all natural persons who are owners of the above described unit.

Owner Owner

E We are President, Vice-President, and Secretary or Assistant Secretary of the corporationnamed which owns the described unit.

President/Vice President Secretary/Assistant Secreta ry

t] | am a General Partner of the generalor limited partnership named:

which owns the above described unit.

General Partner

r-llJ I am the trustee of the trust named _ which owns the

above desribed unit.

Trustee

Revised: 2019.12.09

Page 9: SAIE T DATE: t-r l l From Lease · 2020-02-19 · 24701 US Hwv 19 North Clearwater, FL 33763 Phone: 727 726-8OOO Fax: 727 723-tLOt Email Application to: GReed@ameritechmail.com Page

RULES AND REGULATIONSFOR

ROTHMOOR ESTATES CONDO ASSOCIATION, Inc.

This is a brief summary of Rothmoor Estates Rules and Regulations. A more complete set can befound in the documents.

These regulations apply to all residents, whether owners or tenants, as well as their guests. Thecondominium documents provide for methods whereby these rules can be enforced. Infractionswill not be tolerated.

Residents shall not commit, or permit the commission of any activity which would constitutea nuisance to other residents, to wit:

a. No loud playing of radio, television or other equipmentb. No commission of any immoral or illegal actionsc. No pets are allowed

No peddling, soliciting, or commercial enterprises of any kind.

No signs of any kind shall be displayed within the boundaries of ROTHMOOR ESTATES,except those used by the association. An owner wishing to dispose of their unit, may placea sign in the window or door indicating the fact the said unit is for sale.

Cable television connections have been provided for each unit. No individual exteriorantennas or dishes, whether for television or radio, will be installed or permitted, withoutwritten permission from the Board of directors.

The speed limit within Rothmoor Estates is 10 miles per hour.

There is no storage on the premises or overnight parking, of any trailer, camper, motorcycle(except within the garage of the owner), boats or other vehicles or modes of transportationother than automobiles or noncommercial trucks. Resident parking should be in the owner'sgarage or on the driveway. Other vehicles should be parked in the designated areas ateither end of Rothmoor's streets. No overnight parking on the street is allowed.

Residents and guests should be properly attired at all times for activity in which they areengaged.

Recreation area and pool restrictions:

a. The swimming pool will be closed daily at 10:00 PM

b. Residents should control the use of the pool by guests and visitors who are present attheir invitation.

c. Use of suntan oils or lotions is not permitted in the pool area.

1.

2.

4.

5.

7.

Page 10: SAIE T DATE: t-r l l From Lease · 2020-02-19 · 24701 US Hwv 19 North Clearwater, FL 33763 Phone: 727 726-8OOO Fax: 727 723-tLOt Email Application to: GReed@ameritechmail.com Page

d. Food and glass containers must be kept away from pool decks and must not be takeninto the pool.

e. Persons with long hair must wear bathing caps or tie their hair back in the pool.

f. Children will not be allowed in the pool and recreation areas unless accompanied by aresident host who shall be responsible for the children at all time.

g. All residents or guests must wear foot wear and cover-ups in recreation areas andcommon areas at all times.

h. Residents and guests shall not bring any alcoholic beverages into the recreational areasat any time unless to a function specifically sponsored by the Board of Directors and atthat time within the limitations prescribed by written notice from the board concerningsuch function.

i. Individual owners, who hold private parties in the recreational facility, shall beresponsible for the conduct of their guests therein and in the event alcoholic beveragesare served, they shall "be responsible for the actions of their guests to the extent thatthey are influenced by the use of alcoholic beverages." They shall also be responsiblefor cleaning and leaving the premises in the same condition as before said party.

9. Exterior laundry lines should not be visible from the premises of neighbors and should belocated within the confines of the unit of the owner.

to. Maintenance and upkeep of the common element is the responsibility of the association.Therefore, no individual unit owner should in any way modify or change the exterior of hisunit and/or common areas without written permission via a formal board vote.

11.The community dumpster is located on Mindy Court at the south side of our property. Breakdown boxes before putting them in the dumpster. NEVER leave trash or items on theground inside or outside of the dumpster enclosure.

12.Bulk pick up is NOT provided by the Association. Contractors MUST remove any debrisfrom our premises. "Do lt Yourself' (DlY) owners must call a private trash removal service,pay them directly and have items picked up from their own home.

13. No animals may be kept in the condominium and boarding or taking care of someone else'sanimal on a temporary gr any other basis is not allowed.

14. The recreation hall is available to all Rothmoor residents for communal and limited privateuse. There are no limitations (other than the normal obligation of good conduct) onRothmoor owners who reserve and utilize the recreation hall for functions involvingRothmoor residents and their guests.

Any Rothmoor owner may also reserve and utilize the recreation hall for a private functionwhich involves non-Rothmoor people but, only under the following conditions andlimitations.

Page 11: SAIE T DATE: t-r l l From Lease · 2020-02-19 · 24701 US Hwv 19 North Clearwater, FL 33763 Phone: 727 726-8OOO Fax: 727 723-tLOt Email Application to: GReed@ameritechmail.com Page

a. Reservations for the use of the recreation hall must be filed by a Rothmoor owner inwriting with the Treasurer of the association or his designate, along with a securitydeposit of $150.00 in cash. lf the recreation hall is clean and restored to proper orderthen $75 of the deposit will be returned to the owner unless they have agreed to donateit to Rothmoor.

b. The recreation hall may not be reserved when Rothmoor functions are scheduled or onholidays.

c. Rothmoor owners may reserve the hall for a maximum of two times each year.

d. Rothmoor residents reserving the hall must be present at the reserved function and mustaccept responsibility for the safety and conduct of all non-Rothmoor people attending. lfthere should be damage or cleaning required beyond the value of the $150.00 depbsit,the owners reserving the facility shall be responsible for required cleanup and/or repairs.

e. The recreation hall may not be used for any illegal purpose or by any secret society,group, fraternal, partisan political activity or religious activity of a sectarian nature.

f. lf the recreation hall is reserved for a private party where alcoholic beverages areserved, the Rothmoor residents hosting the party shall be responsible for the actions ofthe guests to the extent that they are influenced by the use of said alcoholic beverages.

THIS is an Adult, no-pet community with limitations set forth that are intended for the welfare,safety and common good of all residents of Rothmoor.

Note: The Board of Directors has the right to interpret the Rules and Regulations for RothmoorEstates Condominium and may bring suit for violation.

I or we have read and understand and signed this document on:

Day Month Year

Unit Purchaser Witness

./, /f,3a70Date

Unit Purchaser

Board of Director

Revised 2020.02.15

Page 12: SAIE T DATE: t-r l l From Lease · 2020-02-19 · 24701 US Hwv 19 North Clearwater, FL 33763 Phone: 727 726-8OOO Fax: 727 723-tLOt Email Application to: GReed@ameritechmail.com Page

Watering Restrictions

The City of Largo purchases its potable water from Pinellas County. Wateringrestrictions for potable and well or pond water are set by the county. The City ofLargo's watering schedule is listed here.

TIMES AND DAYS FOR ROTHMOOR ESTATES

May not water between the hours of gam and Gpm.

Days:

Monday - Addresses ending in 1

Tuesday - Addresses ending in 2-3

Wednesday - Addresses ending in 4-5

Thursday - Addresses ending in 6-7

Friday - Addresses ending in g

Saturday - No watering

Sunday - No watering

Dumpster Pickup

Tuesdays and Fridays

Largo Solid Waste

727 587-6760

Revised 2OL9.t2/LO

Page 13: SAIE T DATE: t-r l l From Lease · 2020-02-19 · 24701 US Hwv 19 North Clearwater, FL 33763 Phone: 727 726-8OOO Fax: 727 723-tLOt Email Application to: GReed@ameritechmail.com Page

FREQ{"j E ruTLY AS K[:E] eU ESTTON S

How will I receive messilges?

A, lt depends on the urgsn6y of the situationand your preferences, Oplions for receivlnqmessages include:

VOICE CALL

(cell or landline or bothdepending on whichphone numbers youhave on file with us)

Nlake sure we haveyour current home,work and/or cell phone

n urn ber on file, A formis provided on the rlght,

EMAIT

(if we have your currentemail address on file)

Provide us with youremiril addressiAformis ptovided on the right,

Provlde us with thecort'ect cell phone

nLjnrber and give us

pr:r.mission to text you

bv c:ompletlng the farmou l:he right,

SMS TEXT MESSAGE

Why do we need a messapfng service?A, By usinE this service, we sre able to bettercommunicqte with resident:s whlle reducing theneed to print and dlstribul:e notices, lt will ulsosllow us to send you urgent messqges such oswe at h e r/ev a cu a ti o ns, n e i gr hb a r h o o d watc hadvlsories, or qmber alert$, We understandthat good communication ls vital to goodcommu nlty re lationshlps I

€- F Willmy contact informarion be kept private?-o None of your personal in,formation will be

shared wlth anyone outside of One Calt Now,Ane Call Now tqkes the security and privacy afyour personal informatian (i,e. phone ,rrLurr,email qddresses) very seriausly. This is neversold or shared * you will not receive any unso-licited calls qs a result af u.sing the serilce,

ero Do I have ro pay any addirtonal fees forbx& this servlce?

No, this service is free to our residents!

NAME

UNIT NUMBER OR ADDRESS

RESIDEruT 1 RESIDFftJT 2

NAME

PRIMARy PHONE (bestem ugency contoct) PRIMARY PHONE (bestem urgurry rontoru

PHONE #2 PHONE #2

PHONE #3 PHONE #3

PHONE F4 PHONE #4

PHONE #5 PHONE #5

PHONE #6 PHONE #6

EMAIL ADDRESS #1 EMAIL ADDRESS #1

EMAIL ADDRESS #' EMAILADDRESS #2

EMAIL ADDRESS #' EMAILADDRESS #3

EMAIL ADDRESS #4 EMAIL ADDRESS #4

EMAIL ADDRESS #' EMAIL ADDRESS #5

SIGNATURESIGNATURE

Page 14: SAIE T DATE: t-r l l From Lease · 2020-02-19 · 24701 US Hwv 19 North Clearwater, FL 33763 Phone: 727 726-8OOO Fax: 727 723-tLOt Email Application to: GReed@ameritechmail.com Page

ROTHMOOR ESTATES

Please Retum to Ameri*Tech Community Management, Inc.24701US Hwy 19 N, Suite 102, Clearwater, FL 33763

E-mail : grced@ameriteehmaii. com - 7 27 -7 ZG-g000 Ext 25 3

]EMERGENCY CONTACT IhIF OR.MATIOIN

Text Cell Phone; YES or N0

Cell #

Nearest contact (relative, f.iend, neighbor) with a key (in ease of emergency)

hlame Phone

Mailing Address

Nearest R.elative (in case of emergency)

Name Phone

Mailine Address

TENANT(s), if applicable

Home Telephone Number

Work Telephone Nurnber

E-mail

Text Cell Phone: YES or NO

Cell #

Number of Pets (and type)

Dogs_Cats_Other

Color TAG Number

Number of Person(s) occupy'ing unit

Adults(s) _ Children __Vehicle(s) Make/Yr Model

FOR OW}IER OR TEI{ANT

PROPER.TY ,{DDRESS UNIT

Please complete the forrn below by PRINTING the requested informafion, sign & date and either hand deliver, mail, orscan & email to Ameri-Tech community Management c/o Gloria Reed"

Homeowners Name(s)

Resident Address Unit

Mailing Address (if different)

Home Telephone Number

Work Telephone Number

Email

PLEASE STGN AND DATE BELOW:

Owner Signature Date Co-Owner Signature (if applicable) Date

= I give permission to shane rny

Rothmoor Estate owners.personal information (phone nurnberso e-mail & address) with other