Homeowner and Tenant Profile

KATONAH MANAGEMENT GROUP, INC.

Property Management Specialists

P.O. Box 1019, Croton Falls, NY 10519-1019

914-276-2750 { (Fax) 914-276-6562

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Mr. Test

January 16, 2003

Page 2

HOMEOWNER AND TENANT PROFILE

Dear Homeowner,

Please fill out the following information as completely as possible. It will enable us to contact you quickly in the event of an emergency. Please indicate your preferred address so that we can be certain that all correspondence reaches you without postal delay. If there are any other contact numbers you would like us to be aware of please include them as well.

Please indicate how you would like to be addressed: (Mr., Ms., Mrs., etc...) Unit#_______

_______________________________

_______________________________

_______________________________

Home Phone:_________________ Work Phone:___________ Name:____________

Fax Number:__________________ Work Phone:___________ Name:___________

Email Address:________________________________________________________

Please indicate all family members (indicate relation) or other residents:

___________________________________________________________________________________________________________________________________________________________

Auto (1) Make/Model:_____________ Color:__________ Year:_________ License:__________ Auto (2) Make/Model:_____________ Color:__________ Year:_________ License:__________

Emergency Contact (with key) ______________________ Telephone No.__________________

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If you have any tenants living in your unit, please provide the following information to complete our records.

TENANTS:

Name(s):______________________________________________________________________

Home Phone:__________________ Work Phone:___________ Name:____________

Work Phone:___________ Name:____________

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