MEMORANDUM

Date: To: The Gardens at Greenview Crossing

From: Sue Clark, SUE CLARK REAL ESTATE SERVICES We are requesting that all homeowners complete this Emergency Contact form. This information will be passed on to the Associations Board of Directors.

I DO NOT want my contact information listed in a community directory.

EMERGENCY CONTACT INFORMATION Primary and secondary contacts should be persons who live off the premises who can be contacted, if you are not available, regarding your unit. Homeowner: Name: Home Phone: Unit #: Wk: Phone (if applicable):

Email address (if applicable): _________________

Primary contact: Name: Secondary contact: Name: Home Phone: Wk: Phone: Home Phone: Wk: Phone:

Please complete this form as soon as possible and mail to: SUE CLARK REAL ESTATE SERVICES P. O. Box 71637 Clive, IA 50325 If you should have any questions please call 222-3191