Fill and Sign the Lifetime Lease 497332520 Form

Tenant’s Intent to Accept Lifetime Lease I, as the tenant of Unit No. ______ of _______________________ (Name of Condominium) located at ________________________________________________ (street address, city, state, zip code) , and being 62 years of age or older at the time of filing of the application for a condominium conversion subdivision of the property, do hereby certify that I have been given a life-time lease subject only to the approval of the final subdivision or parcel map. I have reviewed Section No. _______ of the Subdivision Code that is printed on the reverse side of this form, concerning Life-Time Lease. I hereby declare and certify that it is my intention to exercise the right to which I am entitled under provisions of the aforesaid Section of the Subdivision Code, and accept the Life-Time Lease. Witness my signature this the ____ day of ___________, 20____. _____________________________ (Printed Name of Tenant) _____________________________ (Signature of Tenant) (Acknowledgment form may vary by state) State of _____________________ County of ___________________ Personally appeared before me, the undersigned authority in and for the said County and State, on this _______________ (date) , within my jurisdic tion, the within- named ___________________ (Name of Tenant) , who acknowledged that he executed the above and foregoing instrument. ________________________________ NOTARY PUBLIC My Commission Expires: ____________________