Mold Addendum to Seller's Real Property Disclosure Statement FLORIDA ASSOCIATION OF REAL TORS®

reiumRealty 1NTERNATIONAL A HOMES.!Mcu OF Awrn,""'" c:o....,,,,y AN Jlmu•r< o> BERK•�1�< H•THAWAY

The following amends the Seller's Real Property Disclosure Statement signed by JAIME & MARIELENA GONZALEZ

(seller) on _________ (date) for property located at ___________________ _ 740 BLUEBIRD LN, PLANTATION, FL 33324

The following representations are made by the Seller(s) and are not the representations of any real estate licensees.

1. MOISTURE/WATER INTRUSION INCIDENTS/MOLD

Are You Aware:a. of any instances where moisture/water/condensation/humidity intruded into the structures located on the prop­erty as the result �n, flood, plumbing leak, appliance leak, roof, window or wall leak or any other type of leakor event? NO l!a"\'ESO If yes, explain: __________________________ _

b. of any damage to the structures located on the property includingJ_he_,.growth of mold that resulted from anytype of moisture/water/condensation/humidity intrusion or leak? NOl!,d-'?ESD If yes, explain:. ______ _

c. of any clean up, repairs, or remediation of th �erty including clean up of mold because of moisture or water intrusion/condensation/humidity? N ESLJ If yes, explain: _______________ _

d. of any other problems resulting from moisture/water intrusion/condensation/humidity? NO SO If yes, explain: _____________________________________ _

ACKNOWLEDGEMENT OF SELLER

The undersigned Seller represents that the information set forth in the above disclosure statement is accurate and com­plete to the best of the Seller's knowledge on the date signed below. Seller does not intend for this disclosure statement to be a warranty or guaranty of any kind. Seller hereby authorizes disclosure of the information contained in this disclo­sure statement to prospective Buyers of the property. Seller understands and agrees that Seller will notify the Buyer in writing within five business days after Seller becomes aware that any information set forth in this disclosure statement has become in ccur te or incorrect in any way during the term of the pending purchase by the Buyer.

Seller: �-S,. / JAIME GONZALEZ Date: _3 · I l /! ':)-(print) /

Seller: / MARIELENA GONZALEZ Date: 1 - // - / .s- · (print)

RECEIPT AND ACKNOWLEDGMENT OF BUYER

Seller is using this form to disclose Seller's knowledge of the condition of the real property and improvements located on the property as of the date signed by Seller. This disclosure form is not a warranty of any kind. The information con­tained in the disclosure is limited to information to which the seller has knowledge. It is not intended to be a substitute for any inspections or professional advice the Buyer may wish to obtain. An independent professional inspection is encour­aged and may be helpful to verify the condition of the property and to determine the cost of repairs, if any. Buyer under­stands these representations are not made by any real estate licensee. Buyer hereby acknowledges having received a copy of this disclosure statement.

Buyer:. ______________ _ (signature) (print)

Date: _________ _

Buyer: _______________ /�------------(signature) (print)

Date: _________ _

• formsimplicityMASRPD-1 Rev. 10/02 © 2002 Florida Association of R EALTORs:ID All Rights Reserved

LICENSED TO ESSLINGER"WOOTEN°MAXWELL, Inc., Realtors®

feium RealtyINTERNATIONAL A HOME$ERVICES OF AMERICA TM COMPANY AN AFF1UATE OF BERKSHIRE HATHAWAY

Affiliated Company Business Disclosure

Esslinger. Wooten . Maxwell, Inc., also sometimes referred to as EWM Realty International or

EWM REAL TORS®

, has business relationships with trusted service providers who can assist you with your home financing, title insurance, and closing needs. This is to give you notice of these relationships

with our affiliates and the estimated range of fees they charge for their services.

HOMESERVICES LENDING, LLC is jointly owned by HMSV Financial Services, Inc. (49.9%) and Wells Fargo Ventures, LLC (50.1%)

Columbia Title of Florida, Inc., which also does business under the name of EWM TITLE, is a Subsidiary of Esslinger-Wooten-Maxwell, Inc.

Esslinger-Wooten-Maxwell, Inc. and HMSV Financial Services, Inc. are wholly owned subsidiaries of HomeServices of America, Inc. HOMESERVICES LENDING and EWM TITLE provide a convenient professional package of mortgage and title services. Set forth below is the estimated charge, or range of charges, for each of these affiliated service providers.

HOMESERVICES, LLC Origination Fee of 0-3% of the mortgage loan amount.

Columbia Title up to 1 % of the property purchase price, subject to the services selected by you.

You are not required to use HOME SERVICES LENDING, or EWM TITLE as a condition for your purchase of the property or for the settlement of your loan on the subject property. You may or may not be able to obtain these services at a lower rate by shopping with other settlement service providers.

A lender is allowed to require the use of an attorney, credit reporting agency, or real estate appraiser chosen to represent the lender's interest.

Please review this Disclosure notice, sign below acknowledging your receipt, and retain a copy for your records. Thank you.

/l4}___.c;s. 3 , I/ Date Z,lt', I�

Date

Buyer

o/a124? A , rev Seller

740 BLUEBIRD LN, PLANTATION, FL 33324

Property

Serial#: 083200-000142-5934764

Preoared bv: Rodd Sheradskv I EWM Re,1ltv International I rodd/@roddrealtor.com I 9545602717

Date

4�

Rev. 08/2012

Comprehensive Rider to the /J Jtr Residential Contract For Sale And Purc��se reiumRealty THIS FORM HAS BEEN APPROVED BY THE FLORIDA REAL TORS AND THE FLORIDA BAR INTERNATIONAL

A HOME5EJMC£S OF" A"'El'tiC:.0.1

" CoMPANY AN ArFIUAH OF BEIIIISIHRE Hii,.lf<AWAY

When initialed b all parties, the parties acknowledge that the disclosure set forth low was provided to Buyer prior to execution of the Flo · a Realtors/Florida Bar Residential Contract For Sale and Pure ase between

JAIME & MARI ELENA GONZALEZ (SELLER) and_-:---;;--;:;:------;---',,;--.---.---.,-;;-;;-;STT7FE"5i"'7"7'""-.,,,x,=;;;a;;:;-a;-,,.�';;-----------<BUYER)concerning the Property d cribed as 740 BLUEBIRD LN, PLANTATION, FL 33

Buyer's Initials

WNERS' ASSOCIATIONICOMMU TY DISCLOSURE

IF THE DISCLOSURE SUMMARY QUIRED BY SECTION 720. 1, FLORIDA STATUTES, HAS NOT BEEN PROVIDED TO THE PROSPECTIVE URCHASER BEFORE EX UTING THIS CONTRACT FOR SALE, THIS CONTRACT IS VOIDABLE BY BUYER B DELIVERING TO SELL OR SELLER'S AGENT OR REPRESENTATIVE WRITTEN NOTICE OF THE BUYER'S I ENTION TO CANC WITHIN 3 DAYS AFTER RECEIPT OF THE DISCLOSURE SUMMARY OR PRIOR TO CL ING, WHICHEVE OCCURS FIRST. ANY PURPORTED WAIVER OFTHIS VOIDABILITY RIGHT HAS NO EFFECT. YER'S RIGHT O VOID THIS CONTRACT SHALL TERMINATE AT CLOSING.

BUYER SHOULD NOT EXECUTE THIS CONTRACT TIL B YER HAS RECEIVED AND READ THIS DISCLOSURE.

(a) AS A BUYER OF PROPERTY IN THIS COMMUNI Y, Y U WILL BE OBLIGATED TO BE A MEMBER OF AHOMEOWNERS' ASSOCIATION ("ASSOCIATION").

(b) THERE HAVE BEEN OR WILL BE RECORDED R TRICTIV OVENANTS ("COVENANTS") GOVERNING THEUSE AND OCCUPANCY OF PROPERTIES IN THI COMMUNIT

(c) YOU WILL BE OBLIGATED TO PAY ASSESSME TS TO THE ASS CIATION. ASSESSMENTS MAY BE SUBJECTTO PERIODIC CHANGE. IF APPLICABL , THE CURREN AMOUNT IS $______ PER______ . YOU WILL ALSO BE OBLI ATED TO PAY ANY S ECIAL ASSESSMENTS IMPOSED BY THEASSOCIATION. SUCH SPECIAL ASSESS NTS MAY BE SUBJE T TO CHANGE. IF APPLICABLE, THECURRENT AMOUNT IS $=-:=c-=-ccc--c:==-1'. ER _____ _

(d) YOU MAY BE OBLIGATED TO PAY SPE AL ASSESSMENTS TO THE SPECTIVE MUNICIPALITY, COUNTY,OR SPECIAL DISTRICT. ALL ASSESSM TS ARE SUBJECT TO PERIOD I CHANGE.

(e) YOUR FAILURE TO PAY SPECIAL ASSESSMENTS OR ASSESSME TS LEVIED BY A MANDATORYHOMEOWNERS' ASSOCIATION GOU RESULT IN A LIEN ON YOUR PROP RTY.

(f) THERE MAY BE AN OBLIGATION O PAY RENT OR LAND USE FEES R RECREATIONAL OR OTHERCOMMONLY USED FACILITIES AS N OBLIGATION OF MEMBERSHIP IN TH HOMEOWNERS' ASSOCIATION.IF APPLICABLE, THE CURRENT OUNT IS $ ______ PER---+---

(g) THE DEVELOPER MAY HAVE HE RIGHT TO AMEND THE RESTRICTIVE COVENANTS WITHOUT THEAPPROVAL OF THE ASSOCIAT. N MEMBERSHIP OR THE APPROVAL OF THE P RCEL OWNERS.

(h) THE STATEMENTS CONTAI D IN THIS DISCLOSURE FORM ARE ONLY SUMMARY IN NATURE, AND, AS APROSPECTIVE PURCHAS , YOU SHOULD REFER TO THE COVENANTS AND THE ASSOCIATIONGOVERNING DOCUMENT BEFORE PURCHASING PROPERTY.

(i) THESE DOCUMENTS A EITHER MATTERS OF PUBLIC RECORD AND CAN BE OBTAINED FROM THERECORD OFFICE IN TH COUNTY WHERE THE PROPERTY IS LOCATED, OR ARE NOT RECORDED AND CANBE OBTAINED FROM T. E DEVELOPER.

DATE BUYER

DATE BUYER

Page 1 of 1 B. HOMEOWNERS' ASSOCIATION/COMMUNITY DISCLOSURE CR-3 Rev. 9/14 © 2014 Florida Realtors® and The Florida Bar. Al! rights reserved.

Serial#: 042991-300142-5934763