SEA PINES OF HOBE SOUND HOMEOWNERS ASSOCIATION

10879 SE Sea Pines Circle Hobe Sound FL 33455
Telephone (407) 546-7146

OWNER/RESIDENT AGE INFORMATION

                             PLEASE TYPE OR PRINT

NAME OF OWNER            DATE OF BIRTH     ADDRESS AT SEA PINES
________________________ _________________ ______________________________________

________________________ _________________ ______________________________________

________________________ _________________ ______________________________________

______________                  _________________________________________________
(Unit Number)                   (Signature)

                                _________________________________________________
                                (Signature)

                                _________________________________________________
                                (Signature)

All Tenants in Residency                       Date of Birth
(if Applicable)
____________________________________________   ___________________________

____________________________________________   ___________________________

____________________________________________   ___________________________
(No signature required)

So as to conform with the Federal Fair Housing Amendments Act of 1988 (Public Land 100-430) and to meet the exemption. for housing for older person, this information must be on file with the Association and be updated regularly.

To make this document valid, age verification is needed by either a copy of a drivers license, birth certificate, passport or other legal document stating your age. Please enclose a copy of one of the above with this form.

If you have a tenant in your unit, please obtain the necessary information and copies of proof of age and forward it to the Association. No signature is required by your tenant.

Please keep the Association updated if there is a change in occupancy of your unit.

Thank you for or your help.

SEA PINES OF HOBE SOUND