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| Association Name: | * |
| Association Type: | |
| Association Age: | |
| Number of Homes: | |
| Assessment Frequency: | |
| Assessment Amount or Range: | |
| Current Management Type: | |
| Years with Current Management: | |
| Describe Amenities: | |
| Describe the Most Pressing Issue Facing your Association: | |
| Is The Association Party to any Suit (excluding collections): | |
| Special Assessment History: | |
| Your Name: | * |
| Office Held: | |
| Day Telephone: | * |
| E-mail: | * |
| Mailing Address: | * |
| To prevent automated SPAM, please enter JQCB to submit your form (case sensitive): | * |
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