Confidential Emergency Contact Information Please be advised that at this time we are in the process of updating our records. In the case of an emergency, we may need to contact you or your emergency contact. It is imperative that we have a record of the following: home, work, cell numbers and e-mail address. In the event of an emergency, please provide the name and relationship of someone you authorize, who has your key. The shareholder will be responsible for any damage's that may occur in order to gain access. Accordingly, we would urge that you please return this memo to Diane Duryea with the information as soon as possible. Please do not mail this notice with your monthly payment as they go directly to a bank Lock Box. If there are changes in any of the information, please send an updated form. Copies will be on High Meadow’s website. Your cooperation is greatly appreciated. Name * First Name Last Name Name First Name Last Name Address * Home Phone (###) ### #### Mobile Phone #1 * (###) ### #### Mobile Phone #2 (###) ### #### Email * Emergency Contact Name First Name Last Name Phone (###) ### #### Relationship * Spare Key is with Phone (###) ### #### The above information is complete and correct Your electronic signature below signifies you have read the above statement. * Date MM DD YYYY Thank you!