HUNTERS CREEK HOMES ASSOCIATION DISCLOSURE INFORMATION REQUEST FORM

Print this form, then use your web browser's "Back" button to return to the previous page when finished here.
After completing the form, mail it to: HCHA, P.O. Box 138, Herndon, VA 20172-0138
or phone (703) 435-2481 with the request information.

PROPERTY OWNER:  ___________________________________

PROPERTY ADDRESS: __________________________________, Herndon, VA 20170

I, _____________________________________________, OWNER____ / AGENT ____ request disclosure information about the Hunters Creek Homes Association according to the terms of the Virginia Property Owners’ Association Act (POAA). If you have the owner’s letter of authorization or Power of Attorney, please attach it to this request form. The POAA Act requires the Hunters Creek Homes Association to release the documents ONLY to the owner or his/her authorized agent.

Agent’s Name, Company, Address and Telephone Number:

 ___________________________________________________________________________________

 ___________________________________________________________________________________

Disclosure packet will be picked up by: Owner ___ Agent ___

Daytime Phone:    _______________________

Email Address:    ____________________________

The packet will be available for pick-up fourteen (14) days after we receive your request. If the “ready date” falls on a Saturday, the packet will be available the preceding Friday. To prepare the packet, the Hunters Creek Homes Association will inspect your property and MAY need to go on your property to do so.

Signature of Requester: ___________________________

Daytime Phone: ______________________

(Information below to be completed by Hunters Creek Homes Association)
DISCLOSURE DOCUMENTS FEE: $100.00

PAID BY: Personal Check ______ Certified Check ______ Money Order ______
Check should be made payable to “Hunters Creek Homes Association” or “HCHA”.

DATE RECEIVED: ______________________________________

REQUEST MADE BY: Mail ______ Phone ______
Mail Request to:  Hunters Creek Homes Association, P.O. Box 138, Herndon, VA 20172-0138
Phone Request to:  (703) 435-2481


Last modified Saturday, July 09, 2005 .