APPLICATION FOR MEMBERSHIP OR ASSOCIATE MEMBERSHIP IN
THE LAKE MOHAWK PROPERTY OWNERS ASSOCIATION, INC.

I (we) have participated in the required orientation and hereby make application for membership in the Lake Mohawk Property Owners Association, Inc. I (we) acknowledge receipt and understand that I (we), my family and guests are responsible for abiding by the Constitution, Rules and Regulations, Building and Property Maintenance Codes and any other guidelines established by this Association and/or enacted by the Board of Directors. I also understand that I am bound by the subdivision restriction (Warranty Deed) for the Lake Mohawk subdivision on file with Carroll County, Ohio.

I (we) understand that the payment of an Initiation Fee, Annual Dues and any approved assessment is required of each member of the Association by the restrictions governing Lake Mohawk subdivision of Carroll County, Ohio and the Constitution established by the members of this Association. I (we) agree to pay annual dues and assessments, as established by the membership and Board of Directors, in a timely manner as to the due date for these charges. I (we) further understand that any monies due to the Association on the lots we purchased (for any reason), I (we) are obligated to pay this amount in full.

I (we) acknowledge that I (we) have received a copy of the Association Constitution, Rules and Regulations and the restrictive covenants of the Lake Mohawk subdivision in conjunction with the Orientation and Information Program of the Lake Mohawk Property Owners Association, Inc.

I (we) understand that I (we) must provide the Association with a copy of our Recorded Deed, Land Contract, Lease Purchase Agreement, or in the case of an Associate Member, a copy of the Rental, Lease or Lease Option Agreement.

Date ______________________ Signed _________________________

Witness __________________________ Signed _________________________

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(Office Use Only)
Monies Owed Documents Provided
Initiation Fee $ Copy of Recorded Deed
Dues $ Land Contract
Sewer $ Lease Purchase Agreement
Assessment $ Rental Agreement
Lease Agreement
Total Due Lease Option Agreement

Lot #(s) ________________

Name: _______________________ Age: ________ Phone Number: _____________

Spouse: ______________________ Age: ________

Current Address: ____________________________________________________
(Street Address) (City) (State) (Zip)

Mailing Address: _____________________________________________________
(for newsletter, billings, etc.) (Street Address) (City) (State) (Zip)

Lake Mohawk Address: _______________________________________________
(If different than above) (Street Address) (City) (State) (Zip)

Lake Mohawk Phone Number ________________________

Emergency Phone Number _________________________

Occupation(s) _______________________________________________________

Present Employer and Address: __________________________ _______________

__________________________ ________________________

__________________________ ________________________

Employer Phone Number: __________________________ ____________________

Length of Employment ____________ ____________

Is there a home on this lot? Yes ______ No ______

Do you plan to build on this lot? Yes ______ No ______

Are you buying for recreation? Yes ______ No ______

Is there a co-owner of this lot? Yes ______ No ______

If Yes, provide name and address: ______________________________

______________________________

______________________________

Circle One: Full Membership (owner) or Associate Membership (renter)

Circle One: Purchase Land Contract Lease/Purchase Rental Agmt Lease Lease Option Agmt