Form DBPR CAM2 "Application for Community Association Management Firm License" - Florida

What Is Form DBPR CAM2?

This is a legal form that was released by the Florida Department of Business & Professional Regulation - a government authority operating within Florida. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on May 1, 2015;
  • The latest edition provided by the Florida Department of Business & Professional Regulation;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a printable version of Form DBPR CAM2 by clicking the link below or browse more documents and templates provided by the Florida Department of Business & Professional Regulation.

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Download Form DBPR CAM2 "Application for Community Association Management Firm License" - Florida

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State of Florida
Department of Business and Professional Regulation
Regulatory Council of Community Association Managers
Application for Community Association Management Firm License
Form # DBPR CAM 2
This application is used to request initial licensure of a community association management firm
In order for a firm to offer management services there must be a licensed Community Association
Manager (CAM) on staff.
APPLICATION CHECKLIST – IMPORTANT – Submit items on the checklist below with your
application to ensure faster processing. Always keep a copy of your application and any
supporting documents submitted to the Department.
APPLICATION REQUIREMENTS
Fees:
• $105
• Make check payable to the Florida Department of Business and Professional Regulation.
Each community association management firm must be actively registered and authorized to do
business in this state by filing with the Department of State’s Division of Corporations.
Each community association management firm application must designate a licensed community
association manager who shall be required to respond to all inquiries from and investigations by the
Department.
The community association management firm will employ only licensed community association
managers in the direct provision of community association management services.
For more information regarding licensure requirements please refer to Section 468.432,
Florida Statutes and Chapter 61-20 of the Florida Administrative Code.
Please mail your completed application, documentation and required fee(s) to:
Department of Business and Professional Regulation
2601 Blair Stone Road
Tallahassee, FL 32399-0783
DBPR CAM 2 Firm License
2015 May
Incorporated by Rule: 61-35.020
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State of Florida
Department of Business and Professional Regulation
Regulatory Council of Community Association Managers
Application for Community Association Management Firm License
Form # DBPR CAM 2
This application is used to request initial licensure of a community association management firm
In order for a firm to offer management services there must be a licensed Community Association
Manager (CAM) on staff.
APPLICATION CHECKLIST – IMPORTANT – Submit items on the checklist below with your
application to ensure faster processing. Always keep a copy of your application and any
supporting documents submitted to the Department.
APPLICATION REQUIREMENTS
Fees:
• $105
• Make check payable to the Florida Department of Business and Professional Regulation.
Each community association management firm must be actively registered and authorized to do
business in this state by filing with the Department of State’s Division of Corporations.
Each community association management firm application must designate a licensed community
association manager who shall be required to respond to all inquiries from and investigations by the
Department.
The community association management firm will employ only licensed community association
managers in the direct provision of community association management services.
For more information regarding licensure requirements please refer to Section 468.432,
Florida Statutes and Chapter 61-20 of the Florida Administrative Code.
Please mail your completed application, documentation and required fee(s) to:
Department of Business and Professional Regulation
2601 Blair Stone Road
Tallahassee, FL 32399-0783
DBPR CAM 2 Firm License
2015 May
Incorporated by Rule: 61-35.020
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Application Instructions:
a) Section I– Business Information
i)
Fill out each section completely.
ii) Provide the name of the community association management firm as it is registered with the
Florida Division of Corporations.
iii) The “Doing Business As” (D/B/A) name must be provided as it is registered with the Florida
Division of Corporations, if the community association management firm uses a fictitious
name to conduct business.
iv) Applicants must provide the Tax Identification Number for the firm to be licensed. (Federal
Employer Identification Number or Social Security number, as applicable.) See
www.irs.gov
for more information.
v) Provide the name and title of the person making application for the community association
management firm. This person should be an owner, officer, or director of the firm authorized
to execute the application for the firm.
vi) Provide the mailing address for the firm. This may be a post office box address.
vii) Provide the physical location of the firm’s main place of business. This address must be a
physical location. A post office box is not acceptable for the business location address.
viii) Provide a valid phone number, fax number and email address. Contact information is often
used to quickly resolve questions with applications by telephone call or email. If contact
information is not provided, questions regarding applications will be mailed to the applicant’s
mailing address and may take longer to resolve.
b) Section II– Designated Licensed Community Association Manager
i)
Provide the name, license number, Social Security number and address for the licensed
community association manager who will be designated to respond to all inquiries from and
investigations by the Department.
c) Section III– Business Ownership Information
i)
The following persons must provide the information requested in this section:
(1) All owners holding greater than or equal to 10% of the firm’s stock or equity;
(2) All officers and directors of the firm.
ii) Provide the name and title of the owner, officer and / or director.
iii) Provide the Community Association Manager (CAM) license number if the owner, officer, or
director holds a CAM license.
iv) Social Security number of the owner, officer and / or director.
v) Provide the address for the owner, officer and / or director.
vi) Please use additional paper if necessary to ensure all owners, officers and directors have
been listed.
d) Section IV – Licensed Community Association Manager Employees
i)
Provide the names and license numbers for all employees who will be employed as
community association managers within the firm.
e) Section V – Affirmation by Written Declaration
i)
The applicant must sign and date the affirmation by written declaration. This should be the
owner, officer or director of the firm authorized to execute the application for the firm, as
provided in Section I of the application.
ii) If the applicant fails to sign the affirmation statement the Department will not process the
application.
DBPR CAM 2 Firm License
2015 May
Incorporated by Rule: 61-35.020
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State of Florida
Department of Business and Professional Regulation
Regulatory Council of Community Association Managers
Application for Community Association Management Firm License
Form # DBPR CAM 2
[3802/1030]
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.
For additional information see the Instructions at the beginning of this application.
Section I – Business Information
BUSINESS INFORMATION
Business Name
Doing Business As (D/B/A)
Tax Identification Number
BUSINESS MAILING ADDRESS
Street Address or P.O. Box
City
State
Zip Code (+4 optional)
BUSINESS LOCATION ADDRESS
Street Address
City
State
Zip Code (+4 optional)
CONTACT INFORMATION
Contact Name:
Telephone Number
Fax Number
Email Address
Section II – Designated Licensed Community Association Manager
DESIGNATED LICENSED COMMUNITY ASSOCIATION MANAGER
Name
License Number
Social Security Number*
Telephone Number
Email Address
Street Address
City
State
Zip Code (+4 optional)
* The disclosure of your social security number is mandatory on all professional and occupational license applications, is solicited by
the authority granted by 42 U.S.C. §§ 653 and 654, and will be used by the Department of Business and Professional Regulation
pursuant to §§ 409.2577, 409.2598, 455.203(9), and 559.79(3), Florida Statutes, for the efficient screening of applicants and
licensees by a Title IV-D child support agency to assure compliance with child support obligations. It is also required by § 559.79(1),
Florida Statutes, for determining eligibility for licensure and mandated by the authority granted by 42 U.S.C. § 405(c)(2)(C)(i), to be
used by the Department of Business and Professional Regulation to identify licensees for tax administration purposes.
DBPR CAM 2 Firm License
2015 May
Incorporated by Rule: 61-35.020
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Section III – Business Ownership Information
BUSINESS OWNERSHIP INFORMATION
Please provide the information requested below for the following persons: (make additional copies as
necessary)
all owners of this company holding greater than or equal to 10% of the firm’s stock or equity
all officers and directors of the firm
Name
Title
CAM License Number (if applicable)
Social Security Number*
Street Address
City
State
Zip Code (+4 optional)
Name
Title
CAM License Number (if applicable)
Social Security Number*
Street Address
City
State
Zip Code (+4 optional)
Name
Title
CAM License Number (if applicable)
Social Security Number*
Street Address
City
State
Zip Code (+4 optional)
Name
Title
CAM License Number (if applicable)
Social Security Number*
Street Address
City
State
Zip Code (+4 optional)
Name
Title
CAM License Number (if applicable)
Social Security Number*
Street Address
City
State
Zip Code (+4 optional)
Name
Title
CAM License Number (if applicable)
Social Security Number*
Street Address
City
State
Zip Code (+4 optional)
* The disclosure of your Social Security number is mandatory on all professional and occupational license applications, is solicited
by the authority granted by 42 U.S.C. §§ 653 and 654, and will be used by the Department of Business and Professional Regulation
pursuant to §§ 409.2577, 409.2598, 455.203(9), and 559.79(3), Florida Statutes, for the efficient screening of applicants and
licensees by a Title IV-D child support agency to assure compliance with child support obligations. It is also required by § 559.79(1),
Florida Statutes, for determining eligibility for licensure and mandated by the authority granted by 42 U.S.C. § 405(c)(2)(C)(i), to be
used by the Department of Business and Professional Regulation to identify licensees for tax administration purposes.
DBPR CAM 2 Firm License
2015 May
Incorporated by Rule: 61-35.020
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Section IV – Licensed Community Association Manager Employees
LICENSED COMMUNITY ASSOCIATION MANAGER EMPLOYEES
Name
License Number
Name
License Number
Name
License Number
Name
License Number
Name
License Number
Name
License Number
Name
License Number
Name
License Number
Name
License Number
Name
License Number
Section V – Affirmation by Written Declaration
AFFIRMATION BY WRITTEN DECLARATION
I certify that I am empowered to execute this application as required by Section 559.79, Florida Statutes. I
understand that my signature on this written declaration has the same legal effect as an oath or
affirmation. Under penalties of perjury, I declare that I have read the foregoing application and the facts
stated in it are true. I understand that falsification of any material information on this application
may result in criminal penalty or administrative action, including a fine, suspension or revocation
of the license.
Signature of Authorized Firm
Owner/Officer/Director:
Print Name:
Date:
DBPR CAM 2 Firm License
2015 May
Incorporated by Rule: 61-35.020
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