Resident Information Form

Nottoway Village Residents List – New resident and change information.
ADD________ CHANGE________ DELETE________
Residents Name(s) and Phone Number(s) – Please list a primary phone number, such as a home phone, on the (P) line. A cell number (C) may also be listed for each resident, identify the owner .
NAME: PHONE:
(P)_________________________________
__________________________________________ (C)_________________________________
__________________________________________ (C)_________________________________

Street Address:_______________________________________________________________________

Former Owner: (for new residents only)_____________________________________________________

Email Address – An email address may be listed for each resident, please identify the owner of the email

____________________________________________________________________________________

____________________________________________________________________________________

Please return to: Donna Kettish 4604 Nottoway Dr. cranesroost765@gmail.com 410-549-7489