FL Affidavit of Disclosure - Miami-Dade County Lake Belt Area 1

Required by Chapter 373.4149, F.S.

STATE OF FLORIDAFOLIO# ___ - ___ - ___ - ___

COUNTY OF MIAMI-DADE

Before me, the undersigned authority, personally appeared __________________________, Affiant, who being by me duly sworn, on oath, depose(s) and say(s):

As required by Chapter 373.4149(5), Florida Statutes (F.S.), Affiant hereby acknowledges that the subject real property identified above by folio and further described in Exhibit X attached, is located inside, or within two miles of, the Miami-Dade County Lake Belt Area, established by the Florida Legislature in Chapter 373.4149(3), F.S., and further acknowledges the following:

• Affiant holds title to the subject real property proposed to be sold, leased, used or developed.
  
• Limestone mining activities involving the use of explosives exist within close proximity of the subject real property.
  
• Affiant is required to submit this affidavit of disclosure to Miami-Dade County at the time of first application for a development approval of any type on or after October 1, 1999.
  
• Affiant shall provide copies of this affidavit of disclosure to all subsequent parties to whom whole or part interest in the real property is transferred, by sale, lease, or any other means.
  
• Failure to provide this affidavit of disclosure to all subsequent parties could result in potential civil liability, as well as fines and penalties pursuant to Section 373.4149 F.S.
  
• Failure to provide this affidavit of disclosure makes the sale of the real property or interest therein voidable at the purchaser's option for a period of seven (7) years from the date of the affidavit of disclosure.

______________________________

Affiant's Signature

______________________________

Print Name

______________________________

Address

Sworn to and subscribed before me on the ______ day of _______________, yr.: _____.

Affiant is personally known to me or has produced _____________________ as identification.

(Stamp/Seal) ____________________________

Notary

My Commission Expires: