Key Fob Form

Address: ______________________________

Resident (Homeowner or Tenant)	Second Key Fob
Name: ______________________________	Name: ______________________________
Phone: ______________________________	Phone: ______________________________
e-mail: ______________________________	e-mail: ______________________________
Male	Male
Female	Female

Landlord Authorization for Tenants:

I, (owner) ____________________________________________________________, own

the premesis at (address) __________________________________________________.

I presently rent my unit to (tenant) _______________________________________.

I hereby give my permission to said tenant to receive Key Fob(s) to gain entry to the Clubhouse parking lot. I understand that they may only have access as long as common charges and House Rules fines are current and that I am solely responsible for these fobs.

Homeowner’s Signature:___________________________________________ Date: __________

For Office Use Only

Key Fob 1: ____________ Processed by: ________

Key Fob 2: ____________ Key Fob 2 Payment Received: ____________

I acknowledge the receipt of ____ key fobs. I understand these fobs must be returned to SCHOA
when I am no longer a member of the Association. I also understand that in the event of loss or damage,
a replacement fee of $25.00 will be assessed for each fob and the original fob will be disabled.

Signature:___________________________________________ Date: __________