Dbpr Complaint Form PDF Details

In the state of Florida, the mechanism for reporting violations of standards and practices across a wide array of professions is encapsulated within the DBPR 0070 – Uniform Complaint Form. Crafted under the legal framework of Section 455.225, Florida Statutes, this form serves as a critical tool for individuals seeking to highlight potential breaches of statutory regulations or professional conduct codes overseen by the Department of Business and Professional Regulation. It underscores the state's commitment to maintaining high standards of practice, offering a structured avenue for complaints to be lodged, investigated, and resolved. The process detailed in the form emphasizes the need for complainants to provide comprehensive documentation and information to support their allegations, ranging from contracts and invoices to more specific evidence related to the profession in question. Furthermore, the document outlines the confidential nature of investigations, protecting the information from public release until a determined point in the inquiry process. This level of detail ensures that both the complainant and the subject of the complaint are afforded fairness and transparency throughout the investigation. With its meticulously designed instructions and the requirement for detailed supporting evidence, this form represents the gateway through which the Department of Business and Professional Regulation navigates the complex landscape of professional accountability and consumer protection in Florida.

QuestionAnswer
Form NameDbpr Complaint Form
Form Length7 pages
Fillable?No
Fillable fields0
Avg. time to fill out1 min 45 sec
Other nameshomeowners association complaint form florida, florida condo complaint form, how to file a complaint with dbpr, business complaint

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DBPR 0070 – Uniform Complaint Form Instructions

STATE OF FLORIDA

DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION

Uniform Complaint Form Instructions

Pursuant to Section 455.225, Florida Statutes, a complaint is legally sufficient if it contains ultimate facts that show that a violation of this chapter, of any of the practice acts relating to the professions regulated by the Department, or of any rule adopted by the Department or a regulatory board in the Department, has occurred. The Department may investigate, and the Department or the appropriate board may take appropriate final action on, a complaint even though the original complainant withdraws it or otherwise indicates a desire not to cause the complaint to be investigated or prosecuted to completion.

Please provide all relevant documentation that supports your complaint with this form. No investigation of your complaint can begin until you provide all relevant information and documentation to the Department. Failure to provide this information may result in further requests for information and delay the investigation of your complaint.

Relevant documentation includes, but is not limited to, copies of the following, as applicable:

Contracts/ Proposals

Invoices

Proof of Payment

Advertisements

Correspondence

Authorization for Release of Patient Information Form (Vets)

Community Association Manager (CAM) Meeting Minutes

Management Contract (CAM)

Covenants and By-laws (CAM)

Building Permit (Electrical and Construction)

Lien(s) (Electrical and Construction)

Please send legible copies of your supporting documents. We are unable to return original documents to you.

Should additional documentation be requested and not received by this Department within 30 days of the request, the file may be closed.

If an investigation of any subject is undertaken, the Department will furnish to the subject or the subject’s attorney a copy of the complaint or document that resulted in the initiation of the investigation.

Pursuant to Chapter 455, Florida Statutes, the complaint and all information obtained pursuant to the investigation by the Department are confidential and exempt from public records requests until 10 days after probable cause is found to exist, or until the subject of the investigation waives his or her privilege of confidentiality, whichever occurs first. However, the exemption does not apply to actions against unlicensed persons or unless otherwise provided by law.

Investigations differ in complexity and duration, so providing a time of completion is not possible. We appreciate your cooperation and understanding in this matter.

Rev 07/2011

Page 1 of 5

DBPR 0070 – Uniform Complaint Form

STATE OF FLORIDA

DEPARTMENT OF BUSINESS AND

PROFESSIONAL REGULATION

Please submit to the appropriate address on Page 4.

Any investigation or administrative proceeding brought by the Department against the subject of your complaint will rely upon the information you provide to the Department. All allegations and supporting documentation MUST be provided to the Department at this time.

COMPLAINANT INFORMATION

 

Last Name

 

First

 

 

 

 

 

Middle

Title

Suffix

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Your Company/Occupation

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

MAILING ADDRESS

 

 

 

 

 

Street Address or P.O. Box

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

City

 

 

 

 

 

 

 

 

State

Zip Code (+4 optional)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

County (if Florida address)

 

 

 

 

Country

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

CONTACT INFORMATION

 

 

 

 

 

Primary Phone Number

 

 

 

 

Alternate Phone Number

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Primary E-Mail Address

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Unlicensed Activity Complaint? Yes

 

 

No

 

 

Unknown

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

COMPLAINT DESCRIPTION

 

 

 

 

Attach additional sheets as necessary.

Rev 07/2011

Page 2 of 5

PRIVATE ATTORNEY FOR COMPLAINANT (IF APPLICABLE)

 

Last Name

First

Middle

Title

Suffix

 

 

ADDRESS

 

 

Street Address or P.O. Box

 

 

 

 

City

 

State

Zip Code (+4 optional)

County (if Florida address)

 

Country

 

 

 

CONTACT INFORMATION

 

 

Primary Phone Number

 

Alternate Phone Number

 

 

SUBJECT OF COMPLAINT

 

Last Name

First

 

 

Middle

Title

Suffix

 

 

 

 

 

 

 

 

 

 

 

License Number (if known)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Company/Occupation

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

MAILING ADDRESS

 

 

 

 

Street Address or P.O. Box

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

City

 

 

 

State

Zip Code (+4 optional)

 

 

 

 

 

 

 

 

 

 

 

County (if Florida address)

 

 

Country

 

 

 

 

 

 

 

 

 

 

 

 

CONTACT INFORMATION

 

 

 

 

Primary Phone Number

Primary E-Mail Address

 

 

 

 

 

 

 

 

 

RESIDENCE ADDRESS (IF DIFFERENT THAN MAILING ADDRESS)

 

 

 

Street Address

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

City

 

 

 

State

Zip Code (+4 optional)

 

 

 

 

 

 

 

 

 

 

 

County (if Florida address)

 

 

Country

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

PRIVATE ATTORNEY FOR SUBJECT OF COMPLAINT (IF APPLICABLE)

 

 

 

Last Name

First

 

 

Middle

Title

Suffix

 

 

 

 

 

 

 

 

 

 

 

ADDRESS

 

 

 

 

Street Address or P.O. Box

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

City

 

 

 

State

Zip Code (+4 optional)

 

 

 

 

 

 

 

 

 

 

 

County (if Florida address)

 

 

Country

 

 

 

 

 

 

 

 

 

 

 

 

CONTACT INFORMATION

 

 

 

 

Primary Phone Number

 

 

Alternate Phone Number

 

 

 

 

 

 

 

 

 

 

 

 

 

Rev 07/2011

 

 

 

 

 

Page 3 of 5

 

WITNESS (IF APPLICABLE)

 

Last Name

First

 

 

Middle

Title

Suffix

 

 

 

 

 

 

 

 

 

 

 

 

 

ADDRESS

 

 

 

 

Street Address or P.O. Box

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

City

 

 

 

State

Zip Code (+4 optional)

 

 

 

 

 

 

 

 

 

 

 

County (if Florida address)

 

 

Country

 

 

 

 

 

 

 

 

 

 

 

 

CONTACT INFORMATION

 

 

 

 

Primary Phone Number

 

 

Alternate Phone Number

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

WITNESS (IF APPLICABLE)

 

 

 

 

Last Name

First

 

 

Middle

Title

Suffix

 

 

 

 

 

 

 

 

 

 

 

ADDRESS

 

 

 

 

Street Address or P.O. Box

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

City

 

 

 

State

Zip Code (+4 optional)

 

 

 

 

 

 

 

 

 

 

 

County (if Florida address)

 

 

Country

 

 

 

 

 

 

 

 

 

 

 

 

CONTACT INFORMATION

 

 

 

 

Primary Phone Number

 

 

Alternate Phone Number

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

I affirm that I have provided the above information completely and truthfully to the best of my knowledge.

Complainant Sign Here:

 

Date:

 

 

 

 

Rev 07/2011

Page 4 of 5

Please mail the completed Uniform Complaint Form to the appropriate address below:

Board of Accountancy

Division of Real Estate

240 N.W. 76th Drive, Suite A

400 Robinson Street

Gainesville, Florida 32607

Orlando, Florida 32801

For the following professions:

Please mail the completed Uniform Complaint form

 

to: Department of Business and Professional

Asbestos Contractors and Consultants

Regulation

Athlete Agent

Division of Regulation/Compliance -Consumer

Auctioneers

Services

Barbers

1940 North Monroe Street

Boxing, Kick Boxing and Mixed Martial Arts

Tallahassee, Florida 32399-0782

Building Code Administrators & Inspectors

 

Child Labor

 

Community Association Managers and Firms

 

Construction Industry

 

Cosmetology

 

Electrical Contractors

 

Employee Leasing Companies

 

Farm Labor

 

Geologists

 

Harbor Pilots

 

Home Inspectors

 

Labor Organizations

 

Landscape Architecture

 

Mold-Related Services

 

Talent Agencies

 

Veterinary Medicine

 

Rev 07/2011

Page 5 of 5

DBPR CAM 4307 – Additional Information Request Questionnaire

page 1 of 2

STATE OF FLORIDA

DEPARTMENT OF BUSINESS AND

PROFESSIONAL REGULATION

1940 North Monroe Street

Tallahassee, FL 32399-0783

Note: This form must be submitted with

DBPR 0070 Uniform Complaint Form

If you have any questions or need assistance in completing this application, please contact the Department of Business and Professional Regulation, Customer Contact Center, at 850.487.1395.

STATUTORY DEFINITION OF COMMUNITY ASSOCIATIONS

Name of Association

Address of Association

1.

Is this a residential homeowner’s association in which membership in the

 

 

 

association is a condition of ownership of the unit?

Yes

No

 

 

 

 

2.

Is the association authorized to impose a fee which may become a lien against

 

 

 

a unit if not paid?

Yes

No

What is the total number of units within the association?

PERFORMING AS A COMMUNITY ASSOCIATION MANAGER (CAM)

Name of the Subject

Is the Subject employed by one or more associations or by a company that

 

provides services to one or more associations?

Yes No

If yes, how many associations are involved?

Name of association(s) and/or company

Total number of units in all associations

Does the Subject receive compensation (for instance, a salary, reduction in

 

rent or fees, free rent, or any other benefits) for his or her services?

Yes No

What is the total dollar amount of the association’s annual budget(s)?

2004 October 14

CAM: Additional Information Request

 

DBPR CAM 4307 – Additional Information Request Questionnaire

page 2 of 2

 

 

 

 

 

 

 

 

 

 

SPECIFIC DUTIES

 

 

 

Does the Subject have the authority to control or disburse association funds, for instance:

 

 

 

 

 

 

 

a. Does the Subject receive funds from unit owners either by check or cash?

Yes No

 

b.What does the Subject do with the funds: write receipts, make bank deposits?

c. Does the Subject post funds to the accounts?

Yes No

d.Does the Subject have the authority to sign checks and does the Subject

sign the checks?

Yes No

e.Does the association maintain a petty cash fund and is the Subject

 

authorized to spend petty cash?

Yes

No

f.

Does the Subject have the authority to make changes in the association accounts?

Yes

No

 

 

 

 

g.

Does the Subject work directly for a licensed CAM or is he/she a licensed CAM?

Yes

No

 

If yes, what is the name and license number of the CAM?

 

 

 

 

 

Can the Subject incur charges on association accounts?

Yes

No

Who approves invoices for payment (work completed, supplies delivered)? (Name and Address)

Does the Subject have input regarding the monthly or yearly financial statements?

Yes

No

If yes, explain:

 

 

 

 

 

Does the Subject have input in preparing the annual budget?

Yes

No

If yes, explain:

 

 

 

 

 

Does the Subject determine when or how to provide notice of association meetings?

Yes

No

 

 

 

Does the Subject conduct the association meetings?

Yes

No

 

 

 

Does the Subject coordinate the overall operation of the association?

Yes

No

 

 

 

Does the Subject supervise other association employees?

Yes

No

 

 

 

Who do unit owners notify with maintenance problems?

 

 

 

 

 

Is the Subject a registered agent for the association?

Yes

No

 

 

 

Does the Subject perform clerical functions under the direct supervision and

 

 

control of a licensed CAM?

Yes

No

If yes, what is the name and license number of the CAM?

 

 

 

 

 

Does the Subject perform only maintenance services?

Yes

No

 

 

 

ADDITIONAL INFORMATION (attach additional pages if needed):

 

 

I certify the above is true and correct to the best of my knowledge and belief.

_____________________________________________ ____________________________

(Signature)(Date)

_____________________________________________

(Print Full Name)

2004 October 14

CAM: Additional Information Request

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