STATE OF CALIFORNIA DEPARTMENT OF REAL ESTATE SUBDIVISIONS PUBLIC REPORT AMENDMENT APPLICATION (non-substantive change) RE 635B (Rev. 5/03) GENERAL INFORMATION ✔ This form may only be used for a change in the name of the subdivider [Reg. 2790.1(d)] or any other recurring and non-substantive change. ✔ This form may not be used where there is a change in the ownership of the subdivision. ✔ Submit original RE 635B and one photocopy of page one; attach fee to the copy of this page. FOR OFFICE USE ONLY 1. TYPE OF SUBDIVISION [Check appropriate box(es)] STANDARD DATE RECEIVED FILE NUMBER MOBILE HOME CONDOMINIUM AMOUNT REQUIRED CONVERSION STOCK COOPERATIVE $ LIMITED EQUITY HOUSING COOPERATIVE (LEHC) AMOUNT RECEIVED PLANNED DEVELOPMENT $ COMMUNITY APARTMENT REFUND AMOUNT TIME-SHARE - SINGLE SITE TIME-SHARE - MULTI-SITE 2. SUBDIVISION IDENTIFICATION AND LOCATION $ 3. SUBDIVIDER INFORMATION DRE FILE NUMBER NAME PREVIOUS DEPUTY ASSIGNED FILE ATTENTION NAME OF SUBDIVISION ADDRESS TRACT NUMBER CITY NAME TO BE USED IN ADVERTISING STATE ZIP CODE STREET ADDRESS (OR NEAREST CROSS STREETS) TELEPHONE NUMBER (INCLUDE A/C) FAX NUMBER 4. SINGLE RESPONSIBLE PARTY (SRP) CITY NAME COUNTY ATTENTION IF SUBDIVISION IS LOCATED WITHIN CITY LIMITS, LIST NAME OF CITY. ADDRESS IF RURAL SUBDIVISION, LIST NAME OF NEAREST TOWN/CITY. CITY LIST THE MILES/DIRECTION FROM NEAREST TOWN/CITY. STATE ZIP CODE TELEPHONE NUMBER (INCLUDE A/C) FAX NUMBER CHECK APPROPRIATE BOX(ES) All residential lots/units to be sold vacant. All residential lots/units to be sold with completed residential structures. Residential lots/units to be sold both vacant and improved with residential structures. All lots to be sold as raw land. All lots/units to be sold with age restrictions. All lots/units to be leased ________________ WHEN PUBLIC REPORT IS APPROVED: MAIL TO SRP CALL SRP FOR PICK-UP American LegalNet, Inc. www.FormsWorkflow.com RE 635B 5. Page 2 of 3 This amended public report will cover the following interests: ____________________________________________________________________________________ 6. I am familiar with the contents of DRE Subdivision File No. ___________________. The offering to be made under authority of this amended public report is identical, except for the changes listed below, to the terms and provisions of the offering as documented in the subdivision file and/or disclosed in the most recently issued subdivision public report. ____________________________________________________________________________________ ____________________________________________________________________________________ 7. Submit a copy of the most recently issued subdivision public report for this offering. 8. Submit documentation reflecting the change in the subdivider’s name. 9. Is the subdivider a California resident? ................................................................................................. Yes No If a nonresident of the State of California, submit an irrevocable consent (original and one copy of the appropriate RE 608 reflecting the subdivider’s new name), that if any action is commenced against the subdivider in the State of California and personal service of process upon the entity or individual cannot be made in this State, a valid service may be made by delivering the Consent to Service of Process (RE 608’s) to the California Secretary of State. 10. Usage Requirements — Name change only [Reg. 2790.1(d)] a. If this application is an expedite, please provide justification. b. The fee is $125 for the first application. Additional application fees are $60. All applications must be submitted at the same time. c. Submit a letter from the surety provider stating that all outstanding bonds, letters of credit, etc., will be honored for the newly named subdivider. Bond riders will be acceptable. A copy of the signed letter must be forwarded to the escrow holder. d. Submit a current preliminary title report issued within 90 days of submittal of the application and signed by a title officer or their authorized agent. The preliminary title report must include the Department of Real Estate notes. e. Submit evidence from the Secretary of State that this is only a name change, not a merger, reorganization or creation of a new entity. Submit a copy of the Certificate of Amendment filed with the Secretary of State. f. Submit a letter from the authorized person or developer indicating that the only change on the approved sample deposit receipt, escrow instructions, grant deed, subsidy or maintenance agreements (if any) is the name change. g. Submit a Certificate of Status for any foreign entity, out-of-state corporation or limited liability company, issued by the California Secretary of State. h. Submit a Consent to Service of Process (Public Report, Permit or Registration - Out of State Trustee) [RE 608C], if applicable, for an out-of-state corporation or developer. i. The subdivision public report will include only the unsold lots/units shown in the current preliminary title report. j. The subdivider can use the Final Subdivision Public Report Amendment (RE 618B ) and attach it to the latest public report that was issued or the SRP can submit a completely retyped public report. American LegalNet, Inc. www.FormsWorkflow.com RE 635B Page 3 of 3 CERTIFICATION I/We hereby certify under penalty of perjury, that there are no changes in the subdivision offering except for the change listed under item 6 and that the information set forth in this application and in the documents appended hereto is true and complete to the best of my knowledge and belief and that I/we am/are the owner(s) of the lots, units or parcels herein described, or will be the owner(s) at the time lots or parcels, improved or otherwise, are offered for sale or lease to the general public — or that I am the agent authorized by such person(s) to complete this statement. The undersigned understands and agrees: 1. That no sales or leases will be made until a change of name addition or any other recurring and non-substantive change addition to the public report is issued. 2. That the filing of a complete subdivision amendment/renewal questionnaire (RE 635 or 635A) and fee may be required by the Real Estate Commissioner upon receipt of this Amendment Application if there are changes which are non-recurring and substantive. 3. That any material changes pertaining to the offering must be promptly reported to the Department of Real Estate. 4. That all interests will be sold in conformance with the previously issued subdivision public report either amended or final covering the interests listed in item 5. Note: • Certification signed outside the State of California must be acknowledged by a notary public. • Prior to signing, review all answers submitted. Errors or omissions must be corrected and initialed by the subdivider(s). • If the subdivider is a corporation, limited liability company (LLC), partnership, etc., the individual(s) signing the certification must stipulate the capacity (e.g., president, manager, general partner, etc.) of the signer and an authorization to sign (e.g., a corporate resolution, LLC statement, partnership statement, etc.) must be submitted. • If an agent will be submitting documents to Department of Real Estate on behalf of the subdivider, the subdivider must provide written authorization to that effect. SIGNATURE OF SUBDIVIDER DATE Ø PRINTED NAME OF SUBDIVIDER CAPACITY NAME OF CORPORATION, LLC, PARTNERSHIP, ETC. SIGNATURE OF SUBDIVIDER DATE Ø PRINTED NAME OF SUBDIVIDER CAPACITY NAME OF CORPORATION, LLC, PARTNERSHIP, ETC. BUSINESS ADDRESS CITY COUNTY STATE American LegalNet, Inc. www.FormsWorkflow.com