Step 1 of 8 12% Community Name*Property Address* Street Address Address Line 2 City StateAlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Where would you like to receive mail?* Property Address Other Address Mailing Address* Street Address Address Line 2 City StateAlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code How would you like to receive statements?* Mail E-mail None (do not send) Email Address* Please provide us with a valid email address where you would like to receive e-statements. You will not receive statements by mail. If you elect to receive e-statements, you will be responsible for keeping your email address current with Ponderosa Community Management. Failure to receive a statement via email or US mail does not relieve you of the requirement to pay your association assessments on time. Homeowner InformationLegal Owners*List all legal owners. Use + sign to the right to add additional owners.Full NameOccupant YesNo Owner Contact Information*Provide contact information for each owner listed above. Numbers (1,2,3) on the left should correspond to the owner numbers above. Use + sign to the right to add additional owner contact information fields.MobileHomeWorkEmail Emergency ContactsList one emergency contact for for each owner.Emergency ContactPrimary PhoneAlternate PhoneEmailRelationshipKey? NoYes Tenant InformationIs your unit rented/leased?* Yes No TenantsList all tenants. Use + sign to the right to add additional tenants.Full NameRelative? NoYes Tenant ContactProvide contact information for each tenant listed above. Numbers (1,2,3) on the left should correspond to the tenant numbers above. Use + sign to the right to add additional tenant contact information fields.MobileHomeWorkEmail Tenants' Emergency ContactsList one emergency contact for for each tenant.Emergency ContactPrimary PhoneAlternate PhoneEmailRelationshipKey? NoYes Property ManagerDo you have a property manager?* Yes No Property Manager InformationNameCompanyPhoneEmail Address Street Address City StateAlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Where should association correspondence be sent? Property Manager Owner On Site VehiclesList All On Site VehiclesMakeModelYearColorPlateStateParking Pass/Permit No. On Site PetsList All On Site PetsTypeNameBreedSize (S,M,L) WeightLicense # DogCatBird Hot Water HeaterIf available, please provide us with information about your hot water heater.Date Installed/ReplacedModel #Serial #Warranty Years Completed BySignature*Printed Name* First Last Date Completed* Δ
