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Annual Owner Notice Disclosure
(Civil Code section 4041)

California law requires Owners in a community association to provide the following information to the association on an annual basis. Please complete and submit this form.

Association (required)

Owner's Email:(required)

Owner's Name(s):

Property Address(s):

Home Phone:

Cell Phone:

Work Phone:

1. Address or Addresses to which notices from the association are to be delivered (Primary Mailing Address):

 Property Address Other (List Below)

2. Any alternate or secondary address to which notices from the association are to be delivered (Secondary Mailing Address):

Note: Providing a secondary mailing address requires that the Association mail a secondary notice of the annual budget report, annual audit and collection matters to both the primary and secondary mailing address, which will result in an increased cost to the Association.

3. The name and address of your legal representative, if any, including any person with power of attorney or other person who can be contacted in the event of your extended absence from your property:

4. Your property is (please check one):

 owner occupied rented out

Provide Tenant Contact Information (If applicable):

Tenant's Name(s):

Tenant's Contact Phone/Email:

5. Is your property developed but vacant (please check one)?:

 Yes No

DESIGNATION FOR OPTING-OUT OF DISCLOSURE OF PERSONAL INFORMATION

If you do not want your name and address to be disclosed to other members of the Association, you may elect to have the Association withhold your private information. To opt-out of sharing your name, property address, mailing address and email address with other members of the Association that may request the membership listing, complete this form and return it to Cardinal Property Management, Inc., as noted on the bottom of the form. Membership lists are only provided to a homeowner when a legitimate written request has been received, in accordance with California Corporations Code.

*This opt-out shall remain in effect until changed by you, via written notification to the Association, through the Managing Agent.

Please select either to "Opt-Out" or "Not Opt-Out" below:

I/We opt-out of the sharing of my/our name, property address, mailing address and email address under the Association membership list, pursuant to Civil Code Section 5220. I prefer to be contacted via the alternative process described in Corporations Code Section 8330(c). This opt-out shall remain in effect until changed by me/us via written notification to the Association’s Managing Agent.

I/We do not opt-out of the sharing of my/our name, property address, mailing address and email address under the Association membership list.

 Opt-Out Not Opt-Out