The Hampshire Property Management Group, Inc.

150 Main Street, 3rd Floor; PO Box 686; Northampton, MA 01061

Randolph Place Condominium Trust Fact Sheet Pursuant to M.G.L. 183A $4(4)

The information should be provided within 60 days of all changes in ownership or occupancy. This form should be completed by the Unit Owner(s) and should be kept current with each change of occupancy. Please return completed form to: The Hampshire Property Management Group, Inc. P.O. Box 686. Northampton, MA 01061 info@hpmgnoho.com

(if no changes, please fill out Section I only and return to our office)

Emergency Contact Please provide an alternative contact person in the event you cannot be reached during an emergency.

SECTION 2: Occupant Information

Owner Occupied? YES NO (please circle one)

Are there any pets in the unit? YES NO If yes, how many and what kind?

SECTION 3: Vehicle Information - Complete for all owner vehicles that will be parked regularly on the premises.

Vehicle Information - Complete for all tenant vehicles that will be parked regularly on the premises.