Emerald Green Property Owners Association, Inc.
P.O. Box 65 · Rock Hill, NY 12775
Phone 845-796-2410 Fax 845-796-2430
Email brittany@emeraldgreenpoa.com
Closing Form
All information should be provided. The information below is needed to change the owner of record in our system. In
addition, a copy of the Contract of Sale is required by our office prior to issuing the Waiver of Right of First Refusal.
Address of Property:___________________________________________________________________________
Section:___________ Block:___________ Lot:___________
Closing Date:___________ / ___________ / ___________
Contact Information—Purchaser 1
Name:________________________________ Date of Birth: ___/___/_____ Social Security #:_____-____-_______
Home Phone:__________________________________ Cell Phone:______________________________________
Email:________________________________________________________________________________________
Contact Information—Purchaser 2 (if applicable)
Name:________________________________ Date of Birth: ___/___/_____ Social Security #:_____-____-_______
Home Phone:__________________________________ Cell Phone:______________________________________
Email:________________________________________________________________________________________
Mailing Address after Closing:
_______________________________________________
_______________________________________________
Receipt of Rules and Regulations
As of September 28, 2007, our office requires a signed Receipt of Rules and Regulations from the purchaser before a Right of
First Refusal is given.
The EGPOA’s By-Laws and Rules and Regulations (including the Building Code) are available on the internet at
www.emerald greenpoa.com, and it is the responsibility of the property owner to familiarize him/herself with these
documents. (Copies may also be obtained by contacting the office at the number above.)
I have read and agreed to abide by the Building Code, By-Laws, & Deeds Covenants & Restrictions
Purchaser(s) (Please Print)
_______________________________________
_______________________________________
_______________________________________
_______________________________________
click to sign
signature
click to edit
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click to sign
signature
click to edit
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