§ 4528 – Escrow Disclosure Form

The form for billing disclosures required by Section 4530 shall be in at least 10-point type and substantially the following form:

Property Address: __________________________________________________

Owner of Property: __________________________________________________

Owner’s Mailing Address (if known or different from property address): __________________________________________________

Provider of the Section 4525 Items: __________________________________________________

Print Name: _______________________ Position or Title: _____________________ Association or Agent: ________________Date Form Completed: ________________
Check or Complete Applicable Column or Columns Below:

Civil Code Section


Fee For Document

Not Available (N/A) or Not Applicable (N/App), or Directly Provided by Seller and confirmed in writing by Seller as a current document (DP)
Articles of Incorporation or statement that not incorporated4525(a)(1)
Operating Rules4525(a)(1)
Age restrictions, if any4525(a)(2)
Rental restrictions, if any4525(a)(9)
Annual budget report or summary, including reserve study5300 and 4525(a)(3)
Assessment and reserve funding disclosure summary5300 and 4525(a)(4)
Financial statement review5305 and 4525(a)(3)
Assessment enforcement policy5310 and 4525(a)(4)
Insurance summary5300 and 4525(a)(3)
Regular assessment4525(a)(4)
Special assessment4525(a)(4)
Emergency assessment4525(a)(4)
Other unpaid obligations of seller5675 and 4525(a)(4)
Approved changes to assessments5300 and 4525(a)(4), (8)
Settlement notice regarding common area defects4525(a)(6), (7), and 6100
Preliminary list of defects4525(a)(6), 6000, and 6100
Notice(s) of violation5855 and 4525(a)(5)
Required statement of fees4525
Minutes of regular board meetings conducted over the previous 12 months, if requested4525(a)(10)

Total fees for these documents: $__________________________________________________

* The information provided by this form may not include all fees that may be imposed before the close of escrow. Additional fees that are not related to the requirements of Section 4525 shall be charged separately.

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