| OWNER ACTION REQUEST | |
| OWNER NAME: | |
| ADDRESS: | |
| CONTACT NAME: | |
| TELEPHONE: | |
| ACTION REQUESTED: | |
| DATE OF THIS REQUEST: | |
| HOW WAS REQUEST SUBMITTED: | FAX MAIL |
| SUBMITTED TO: | Atlantic Realty Management, Inc. |
| 609-926-8060 (office) 609-653-0645 (fax) | |
| DO NOT COMPLETE | BELOW THIS LINE - OFFICE USE ONLY |
| DETAIL ACTION TAKEN: | |
| DATE REQUEST COMPLETED: | |