§ 1. NOTICE OF INTENT TO SOLICIT REAL ESTATE.

   Filing Date:                   

NAME:                                                                                                                   

BUSINESS ADDRESS:                                                                                               

TELEPHONE NUMBER:                                                                                             

Addresses of proposed real estate parcels to be solicited or description of definable area: (attach rider if needed)                                       

Dates of proposed solicitation: (not to exceed a two week period):                                                                                                             

Names of communities in which the person has engaged in solicitation within the preceding six months:

Attach a sample of the material proposed to be distributed, if any:

                  Signature:                                                                               

   BELOW THIS LINE FOR VILLAGE USE ONLY:

DATE:                             

DETERMINATION OF ADMINISTRATOR:                                                                                                             

DATE OF ADMINISTRATOR'S DETERMINATION:                                                       

                  Signature:                                                                               

*The Administrator shall review the material, make a determination and notify the person in writing of the determination within ten (10) days of this date.

(`95 Code, Ch. 94, App. B)