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(1) An estoppel certificate may be completed by any board member, authorized agent, or authorized representative of the association, including any authorized agent, authorized representative, or employee of a management company authorized to complete this form on behalf of the board or association. The estoppel certificate must contain all of the following information and must be substantially in the following form:

(a) Date of issuance:

(b) Name(s) of the parcel owner(s) as reflected in the books and records of the association:

(c) Parcel designation and address:

(d) Parking or garage space number, as reflected in the books and records of the association:

(e) Attorney’s name and contact information if the account is delinquent and has been turned over to an attorney for collection. No fee may be charged for this information.

(f) Fee for the preparation and delivery of the estoppel certificate:

(g) Name of the requestor:

(h) Assessment information and other information:

ASSESSMENT INFORMATION:

1. The regular periodic assessment levied against the parcel is $ per (insert frequency of payment) .

2. The regular periodic assessment is paid through (insert date paid through) .

3. The next installment of the regular periodic assessment is due (insert due date) in the amount of $ .

4. An itemized list of all assessments, special assessments, and other moneys owed on the date of issuance to the association by the parcel owner for a specific parcel is provided.

5. An itemized list of any additional assessments, special assessments, and other moneys that are scheduled to become due for each day after the date of issuance for the effective period of the estoppel certificate is provided. In calculating the amounts that are scheduled to become due, the association may assume that any delinquent amounts will remain delinquent during the effective period of the estoppel certificate.

OTHER INFORMATION:

6. Is there a capital contribution fee, resale fee, transfer fee, or other fee due? (Yes)  (No). If yes, specify the type and amount of the fee.

7. Is there any open violation of rule or regulation noticed to the parcel owner in the association official records? (Yes)  (No).

8. Do the rules and regulations of the association applicable to the parcel require approval by the board of directors of the association for the transfer of the parcel? (Yes)  (No). If yes, has the board approved the transfer of the parcel? (Yes)  (No).

9. Is there a right of first refusal provided to the members or the association? (Yes)  (No). If yes, have the members or the association exercised that right of first refusal? (Yes)  (No).

10. Provide a list of, and contact information for, all other associations of which the parcel is a member.

11. Provide contact information for all insurance maintained by the association.

12. Provide the signature of an officer or authorized agent of the association.

The association, at its option, may include additional information in the estoppel certificate.

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