Filing Statement For Subsequent Phases {CO 6000-3}

DBPR Form CO 6000-3 Effective: 12/23/02 STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION DIVISION OF FLORIDA CONDOMINIUMS, TIMESHARES, AND MOBILE HOMES 1940 NORTH MONROE STREET - NORTHWOOD CENTRE TALLAHASSEE, FLORIDA 32399-1033 TELEPHONE (850)487-9832 FILING STATEMENT FOR SUBSEQUENT PHASES The filing fee of $20 for each residential unit in the phase(s) being filed by the developer as provided by ss. 718.502(3), F.S., must accompany this Statement. If more than one phase is being submitted, attach separate sheets as needed to respond to all questions. NOTE: If the amendments adding the phase(s) are not yet recorded, the developer should submit the recording information to the Division within 120 days of its recordation pursuant to s. 718.403(8), F.S. -----------------------------------------------------------------------------------------------------------------------------------------------------FOR STAFF USE ONLY I.D. No.__________________________________ Recommended_________________________________ Fees Received $___________________________ Reviewed By___________________________________ Form Review______________________________ Current Budget ________________________________ Current Q&A Sheet _________________________ Financial Information, if applicable _________________ -----------------------------------------------------------------------------------------------------------------------------------------------------1) Name of Condominium_______________________________________________________________ Street Address______________________________________________________________________ City_________________________County_________________State____________ Zip____________ 2) 3) Initial Division Identification Number:_____________________________________________________ Identification of phase(s) being filed:_____________________________________________________ __________________________________________________________________________________ 4) Name of Developer/Owner_____________________________________________________________ Address______________________________________________Telephone (____)_______________ City_________________________County_________________State____________Zip_____________ 5) Developer's Attorney/Agent Mailing Address_____________________________________________________________________ City 6) State Zip Code Telephone ( ) Name of Condominium Association Current Mailing Address City State Zip Code Telephone ( Telephone ( ) ) 7) What is the anticipated completion date of each phase being filed?_____________________________ 1 American LegalNet, Inc. www.FormsWorkFlow.com DBPR Form CO 6000-3 Effective: 12/23/02 __________________________________________________________________________________ 8) What is the total number of residential units in each phase being filed? __________________________ __________________________________________________________________________________ 9) Identify documents filed with the initial phase which have been amended or changed with reference to the phase(s) being filed:__________________________________________________________________ ___________________________________________________________________________________ 10) 11) 12) 13) Was the proposed form of amendment adding the phase(s) submitted with the initial filing? Yes__No__ Was a survey and plot plan for the subsequent phase(s) submitted with the initial filing? Yes____No___ Is the Declaration of Condominium recorded? Yes_____No_____ Is the amendment to the Declaration of Condominium adding the phase(s) recorded? Yes___No__ If yes, please provide the following information: Date Recorded__________________________Book__________________Page________________ County where recorded:______________________________________________________________ 14) If the developer has offered for sale or lease residential condominium units described by the attached documents for which there is a filing requirement prior to this filing being submitted to the Division, are copies of all those contracts attached so that the Division may assure that all documents to which purchasers are entitled are in proper form? Yes_____No_____. If the developer has closed on any contracts for sale, or contracts for lease with a lease period of more than five (5) years, prior to notification by the Division that the filing is proper or presumed proper, are copies of those contracts and deeds, if deeded, attached so that the Division may assure that all documents to which purchasers are entitled are in proper form? Yes_____ No ____ . Is the information contained herein true and correct as of the date hereof and no material facts requested have been omitted to the best of your knowledge? Yes______No_______ 15) 16) _________________________________________ (Type or Print Name) ____________________________________________ (Title) _________________________________________ (Signature of Developer/Agent) ____________________________________________ (Date) 2 American LegalNet, Inc. www.FormsWorkFlow.com