ASSESSMENT CERTIFICATE AND ESTOPPEL LETTER

TO:
Fax:
RE: Seller(s):
Property Address:
Buyer(s):
This is to certify the information regarding assessments and fees due to ____________________ for the
above-referenced property:
1.

Owners' Membership in the Association is * Voluntary * Mandatory (Please check one)

2.

The Association:
Has a right of first Refusal: * Yes * No
Has a right of approval of a new purchaser: * Yes * No and (if applicable) * has * has not * approved
the purchaser named above.

3.

There is a Current Balance of Assessments/Fees/Dues Due of $________________________ .

4.

The Assessment/Fees/Dues Amount of $_______________________________

is Paid * Annually * Quarterly * Monthly * Semi-annually (Please check one)

5.

The Assessments/Fees/Dues are currently paid through _________________20____ (Date).

The next Assessment/Fees/Dues billing will be on _________________20____ (Date).

6.

A Transfer Fee of $_________ is to be collected at closing and remitted to the Association.

7.

An Initiation Fee of $_________ is to be collected at closing and remitted to the Association.

8.

Other Miscellaneous Fees to be collected at closing and their amounts are as follows:
$_________ for_____________________

9.

$_________ for_____________________

Please send any funds to be collected at closing, along with a copy of the Warranty Deed to:

______________________________________________
______________________________________________
______________________________________________
(Please note any additional documentation the Association needs from the closing)
Any Checks should be made payable to: ________________________________________.
Signed:______________________________________
Authorized Agent/Officer of _______________________
Dated: ______________________________________
This Certificate is valid for thirty (30) days unless otherwise noted.