Request For Estoppel Certificate
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1REQUEST FOR ESTOPPEL CERTIFICATE
Pursuant to Florida Statutes, request for Estoppel Certificates will be processed within 15 days of receiving your request,
unless you request rush service and agree to the terms outlined for “Rush Request” below.
Requestor must complete all information below and must clearly state the party (name of unit owner / mortgagee) on whose
behalf the request is made. You must be authorized/designated by the unit-owner/mortgagee to request an estoppel.
Estoppel Certificates issued by this firm are conditioned upon the Requestor, contacting the Association’s property manager
and receiving information regarding violations, insurance policies, master/sub associations, etc.
If the Owner wishes to claim the limited liability exception, or the so-called “Safe Harbor” provisions, of Florida Statutes
718.116 or 720.3085, you must provide documentation to substantiate the entitlement (assignment of mortgage, note
indorsement, etc., dated pre-judgment). If you do not, an Estoppel Certificate with all delinquent assessments and other
charges will be provided. Requests to revise an Estoppel Certificate are considered a new and separate request and will only
be processed with payment of the $250.00 estoppel fee in advance, which fee is non-refundable; particularly should
documentation demonstrating Safe-Harbor entitlement not be presented. Therefore, it is in your client’s interest to submit
the requested documentation with the initial request. Estoppel updates requested thirty or more days after an initial
estoppel certificate is provided require a new completed form and fee.
Please mail or deliver your request with payment of $250.00 payable to Wyant-Cortez & Cortez, Chartered.
TO: WYANT-CORTEZ & CORTEZ, CHARTERED, 840 US HWY ONE, SUITE 345, NORTH PALM BEACH, FL 33408-3834
REQUEST DATE: ___________________________
INFORMATION REQUESTED:
☐ Statement of “all assessments and other moneys owed
FR: _____________________________________
to the association.” (Fee: $250.00 payable in advance)
Name of Requestor
☐ Other information requested (May require additional
(Must be unit owner, mortgagee or designee of either)
fee in advance).
______________________________________
_____________________________________
Company Name
PURPOSE OF REQUEST:
(Must be unit owner, mortgagee or designee of either)
☐ Request for payoff to satisfy claim of lien.
☐ Request for payoff to pay association in full.
RE: _____________________________________
☐ Request for payoff in conjunction with closing (provide
Unit Owner
buyer and/or new mortgagee name)
_____________________________________
________________________________________
Unit Owner (continued or second owner)
Date
_____________________________________
________________________________________
Unit Address (Including street and unit number)
Buyer Name
_____________________________________
________________________________________
Condominium or Homeowners Association Name
New mortgagee / lender name (not mortgage broker)
_____________________________________
ENCLOSURES:
Facsimile, Email or Mailing Address to Send Estoppel
☐ Mortgage Assignment to Current Owner (Safe Harbor)
☐ Note with Indorsement to Current Owner (Safe Harbor)
☐ Draft HUD (Short Sales)
RUSH REQUEST
In consideration for expedited processing, I, individually and on behalf of the payor of the estoppel fee, hereby waive any
right to any refund of the estoppel fee that might be claimed under either Florida Statute 718.116(8) or 720.30851.
_________________________
_________________________
_________________________
Signature
Printed Name
Company Name
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