AMENDED AT A REGULAR BOARD MEETING 11/16/88

EXHIBIT "A"

Pet Registration at The Colonies Condominium, McLean, VA

PET:     DOG       CAT     (Circle One)

Sex: ____________________    Breed: _____________________________

General Description: ____________________________________________

Pet Name: _____________________________

Weight (Only 30 lb. maximum at maturity is permissible) _______

Annual Fees: Cat - $10.00

             Dog - $25.00 (1 - 10 lbs.) $35.00 (over 10 lbs.)

Fairfax Reg. No./Expiration Date: ____________________/_________________

Rabies Vac. Cert. No./Expiration Date: ____________________/_________________

________________________________________________________________________

Pet Owner's Name: ____________________________________________

Building and Apartment No. _______-____________

Home Phone: (_______)_______ -__________ Work Phone (_______)_______-__________

By registration of my pet, I acknowledge the pet policies set forth in The Colonies Condominium Policy Resolution No. I-B-8, and certify the the weight of my pet is not in excess of 30 pounds and will not exceed that weight.

 

____________________________________  _______________________

             Signature                           Date

Attest:

____________________________   ______________________________

         Secretary                      President