Application For Approval Of Temporary Resident

AT MOUNT LEBANON
	1150 BOWER HILL ROAD PITTSBURGH, PA. 15243-0986 412-279-0100

Application For Approval Of Temporary Resident

(Please print or type all information)

I/We, __________________________________________, Lessee (s) of Unit No. ___________

in Building No. _______ (The Unit), from Bower Hill At Mt. Lebanon Co. (The Corporation), do

hereby sponsor and request approval for_____________________________ (Name), to be a temporary resident and to reside with me/us in the Unit for the period, not to exceed six (6) months, commencing on______________________________, 20__ and ending on ___________________________, 20__.

I/We and the proposed temporary resident do certify and warrant as follows: Permanent address of the proposed temporary resident is: _________________________________________________________

The motor vehicle identification of the proposed temporary resident is:
____________________ (Make), _________________________ (Model), ______________________ (Color), _______________ (Year),
_________________________ (License No.), ___________________ (State Of Registration).

Lessee(s) is: Friend-Relative-Fiancée (Circle One).

I/We, as Lessee(s) have fully advised to proposed Temporary Resident regarding the provisions and obligations under the Rules and Regulations of the Corporation and under the Proprietary Lease and shall be responsible for the observance and/or any violation thereof by the proposed Temporary Resident.

The proposed Temporary Resident, by signing the application, agrees and warrants that he/she has been fully advised and is knowledgeable concerning the obligations and remedies set forth in the Rules and Regulations of the Corporation and under the Proprietary Lease and that he/she shall observe and be bound by same, as applicable, as fully and completely as Lessee(s) are bound thereby.

Lessee and Temporary Resident acknowledge that this approval of Temporary Resident status may be unilaterally revoked and withdrawn by either the committee or the board have reason or cause, in their sole opinion, to believe that any violation of the Bylaws, House Rules and Regulations, Proprietary Lease, Garage Lease or other association documents has occurred.

IN WITNESS WHEREOF and intending that the foregoing shall be legally binding upon us, we have hereunto set our hands and seals this ______________ day of ___________________, 20__.

_______________________________ (SEAL)

_______________________________ (SEAL)

_______________________________ (SEAL)

(Proposed Temporary Resident)

The Membership Committee of the Corporation, having considered the application for approval of temporary resident on the reverse hereof, recommend to the Board of Directors that said application be:

DISAPPROVED (Circle One).

________________________________

(Chairperson)

Date: ______________, 20__.

The Board of Directors of the Corporation, having considered the application for approval of temporary resident and the recommendation of the Membership Committee, have determined, by majority vote, that the application is

DISAPPROVED (Circle One).

________________________________

(President)

Date: ______________, 20__.

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