If you are requesting a name change, we will reach out to you at the phone number or e-mail address provided if we need more information. 

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* Owner Number

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* Current Name on Owner Share (if you are completing this form and you are not the primary person listed on the above owner share, please skip to the bottom section titled Non-Owner Contact Information)

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* Owner Contact Information

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* Email

Adults in Household (Limit 2)
You may have two members of your household on your owner share.

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* Household members you would like to ADD.

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* Household members you would like to REMOVE.

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* Owner Name Change (if you are the owner listed at the start of this form and you would like to update your name on file, please enter your new name):

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* Non-Owner Contact Information (Only the owner of record can make changes to the owner share. Owner shares are non-transferable).

Do you wish to notify us of an owner's death?

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* If Yes, please provide us with your information below so we can reach out regarding the deceased owner share.

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* Let us know how you'd like to stay connected with the Co-op. Please select all that apply.

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