California > Statewide > Department Of Real Estate > Subdivisions
Public Report Expedited Amendment Application (Term-Provision Change) RE 635A - California
| Public Report Expedited Amendment Application (Term-Provision Change) Form. This is a California form and can be used in Subdivisions Department Of Real Estate Statewide . |
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STATE OF CALIFORNIA PUBLIC REPORT EXPEDITED AMENDMENT APPLICATION (term/provision change) RE 635A (Rev. 5/03) DEPARTMENT OF REAL ESTATE SUBDIVISIONS GENERAL INFORMATION ü Refer to page 4 for RE 635A usage restrictions. ü Submit original RE 635A and one photocopy of page one; attach fee to the copy of this page. 1. TYPE OF SUBDIVISION (CHECK ONE BOX) STANDARD STANDARD MOBILE HOME CONDOMINIUM CONDOMINIUM CONVERSION STOCK COOPERATIVE STOCK COOPERATIVE CONVERSION LIMITED EQUITY HOUSING COOPERATIVE (LEHC) PLANNED DEVELOPMENT PLANNED DEVELOPMENT MOBILE HOME COMMUNITY APARTMENT 2. SUBDIVISION IDENTIFICATION AND LOCATION DRE FILE NUMBER FOR OFFICE USE ONLY FILE NUMBER DATE RECEIVED AMOUNT REQUIRED $ AMOUNT RECEIVED $ REFUND AMOUNT $ 3. SUBDIVIDER INFORMATION NAME PREVIOUS DEPUTY ASSIGNED FILE ATTENTION NAME OF SUBDIVISION ADDRESS TRACT NUMBER CITY NAME TO BE USED IN ADVERTISING STATE ZIP CODE STREET ADDRESS (OR NEAREST CROSS STREETS) TELEPHONE NUMBER (INCLUDE A/C) FAX NUMBER CITY TYPE OF APPLICATION COUNTY CHANGE OF OWNERSHIP (SEE PAGE 3) MERCHANT BUILDER (SEE PAGE 3) 4. SINGLE RESPONSIBLE PARTY (SRP) NAME IF SUBDIVISION IS LOCATED WITHIN CITY LIMITS, LIST NAME OF CITY. IF RURAL SUBDIVISION, LIST NAME OF NEAREST TOWN/CITY. ATTENTION LIST THE MILES/DIRECTION FROM NEAREST TOWN/CITY. ADDRESS IF STOCK COOPERATIVE CONVERSION OR LEHC, IDENTIFY UNIT NUMBERS. CITY CHECK APPROPRIATE BOX(ES) STATE ZIP CODE All residential lots/units to be sold vacant All residential lots/units to be sold with completed residential structures. Residential lots/units to be sold both vacant and improved with residential structures. All lots/units to be sold with age restrictions. All lots/units to be sold as raw land. All lots/units to be leased. TELEPHONE NUMBER (INCLUDE A/C) FAX NUMBER WHEN PUBLIC REPORT IS APPROVED: MAIL TO SRP CALL SRP FOR PICK UP American LegalNet, Inc. www.FormsWorkflow.com RE 635A Page 2 of 4 5. If the sole reason for requesting an amendment is to correct an error in the public report, include a brief explanation concerning the origin of the error(s) being corrected. ____________________________________________________________________________________ ____________________________________________________________________________________ ____________________________________________________________________________________ ____________________________________________________________________________________ ____________________________________________________________________________________ 6. This amended public report will cover the following interests: (Merchant builders see note at bottom of page 3.) ____________________________________________________________________________________ ____________________________________________________________________________________ ____________________________________________________________________________________ 7. I am familiar with the contents of DRE Subdivision File No. ___________________. The offering to be made under authority of this amended public report includes only the following changes in the terms and provisions of the offering from the subdivision file and/or the most recently issued subdivision public report. (Enumerate, describe and append documents, as necessary, to explain/show the changes in the offering. See Regulation 2800 for a listing of material changes.) ____________________________________________________________________________________ ____________________________________________________________________________________ ____________________________________________________________________________________ ____________________________________________________________________________________ ____________________________________________________________________________________ ____________________________________________________________________________________ 8. I have examined the final subdivision public report which has an original issuance date of ____________________ and the last amendment dated ____________________. The following changes to the subdivision public report (or to the amendment, if any) are necessary to reflect the true terms, conditions and provisions of the offering for which an amended public report is requested: (Attach a copy of latest public report with proposed changes red lined.) ____________________________________________________________________________________ ____________________________________________________________________________________ ____________________________________________________________________________________ ____________________________________________________________________________________ ____________________________________________________________________________________ ____________________________________________________________________________________ American LegalNet, Inc. www.FormsWorkflow.com RE 635A Page 3 of 4 9. Submit a current preliminary title report (issued within 90 days of submittal of this application). 10. Submit two original typewritten amended public reports and two photocopies thereof. Also, submit a copy of the new amended public report with the changes underlined in red, and a copy of the most recently issued public report. (Refer to RE 635 Part I for more information regarding the typewritten public report.) CERTIFICATION I hereby certify under penalty of perjury, that there are no changes in the subdivision offering other than those enumerated and described in items 7 and 8, including any attachments pertinent to items 7 and 8, and that the information set forth in this application and in the documents appended hereto is true and complete to the best of my knowledge and belief. · · · · Certification signed outside the State of California must be acknowledged by a notary public. Prior to signing, review all answers submitted. Errors or omissions must be corrected and initialed by the subdivider(s). If the subdivider is a corporation, limited liability company (LLC), partnership, etc., the individual(s) signing the certification must stipulate the capacity (e.g., president, manager, general partner, etc.) of the signer and an authorization to sign (e.g., a corporate resolution, LLC statement, partnership statement, etc.) must be submitted. If an agent will be submitting documents to Department of Real Estate on behalf of the subdivider, the subdivider must provide written authorization to that effect. DATE SIGNATURE OF SUBDIVIDER Ø PRINTED NAME OF SUBDIVI
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