Dbpr Complaint Form – Fill Out and Use This PDF

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:

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

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DBPR CAM 4307 – Additional Information Request Questionnaire

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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)?

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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)

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CAM: Additional Information Request