44025 Courtland Dr., Ashburn VA 20147 | Phone: 703-723-7910 | Fax: 703-723-4674 | www.ashburnvillage.org

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RESALE CERTIFICATE REQUEST FORM

This form is used to order the appropriate Homeowners Documents for selling your home. After you complete the form, please foward your payment to the Association Office unless you have chosen to defer payment to settlement.

Once the Resale Request is received, staff will complete an exterior inspection of your property. Ashburn Village Community Association will inspect the property as required by the Virginia Property Owner's Association Act, Section 55-509.6.

Note to Condominium Owners & Regency Owners:

Resale Certificate packages for condominiums and Regency single-family/townhome/condos must be requested through both Ashburn Village Community Association and your Condo/HOA Management company.

PROPERTY ADDRESS: *

PROPERTY OWNER(S): *

REQUESTED BY (Name and Title): *

THE REQUESTOR IS THE: *

*ENTER NAME OF REAL ESTATE COMPANY OF REQUESTOR: *

CONTACT PHONE: *

CONTACT EMAIL: *

SETTLEMENT DATE (if known): *

RESALE CERTIFICATE PACKAGE OPTIONS

Do you live in Lakeshore Condos, Four Seasons Condos or The Regency? *

Yes

Please indicate Resale Certificate Package option below: *

Electronic Resale Certificate* (via email) - $170.00

Paper Resale Certificate ($205.00)

Rush Fee** ($70.00)

Paper Resale Certificate Update within 12 months of original request ($70.00)

Financial Update 12 months after original request ($70.00)

Please indicate Resale Certificate Package option below: *

Electronic Disclosure (via Email) TH/SF ($315.00)

Paper Disclosure TH/SF ($350.00)

Rush Fee** ($70.00)

Paper Disclosure Update within 12 months of original request ($70.00)

Financial Update 12 months within original request ($58.00)

* Electronic copies require reader such as Adobe Reader

** Additional fee for documents delivered within 5 business days of receipt and payment.

Inspection Fee is included in the cost of Single-Family and Townhome Resale Certificate Packages. Please initial below: *

Homeowners may request additional copies of the Resale Certificate Package. Would you like to request additional copies? *

Yes

How many additional copies do you want? *

Please select the option for your additional copies of the Resale Certificate Package. NOTE: There is a $35 fee for each additional PAPER copy of the Resale Certificate: *

Electronic Resale Certificate (via Email) TH/SF

Paper Resale Certificate TH/SF ($35.00)

Electronic Resale Certificate (via Email) Condo

Paper Resale Certificate Condo ($35.00)

DELIVERY OPTIONS

DELIVERY OPTIONS (Select one): *

Email (For electronic copy only)

Hold for Pick-Up (Paper Copy)

Mail via USPS - Fee: TBD (Paper Copy)

Homeowners may request Resale Certificate Package to be emailed to up to three (3) different email addresses at no additional cost.

Please email the Resale Certificate Package to the following: *

Email Address #2:

Email Address #3:

Please contact me at the following for pick-up (telephone number and/or email address): *

Mailing Address: *

Click the CALCULATE button for the Total Amount Due for the Resale Certificate Package:

$0.00

PAYMENT INFORMATION

PAYMENT: *

Pay Total Amount now. Drop off a check made payable to Ashburn Village Community Association at HOA office or call HOA office with Credit Card information.

Any additional inspection fees will be posted to the seller's account prior to settlement.

By signing below, I understand that under the requirements of the Property Owners Act of Virginia, the Ashburn Village Community Association has fourteen (14) days from the date of receipt of this request to provide such Resale Certificate Package. If the requested Resale Certificate Package is not provided within the fourteen (14) day period, a full refund will be provided along with the requested Resale Certificate Package.

I agree and understand *

that my typed electronic signature below shall have the same legal effect as my original signature and is being accepted as my signature pursuant to the Virginia Uniform Electronic Transactions Act, Code of Virginia, 59.1-479 et seq.

Electronic Signature of Seller or Authorized Agent *

Date: *