Limited Equity Cooperative

							                                     Connecticut Housing Finance Authority
                                       Limited Equity Cooperative Owner Directory
       Please Note: This form is due to CHFA on an annual basis by March 1st or anytime when a change occurs during the year.

 Effective Date                              Name of Owner (Legal Name of Organization)


                                             Legal Address of Organization (i.e. P.O. Box)


                                                                                    President
 Name                                                                               Office Title


 Mailing Address                                                Town                                              State            Zip Code
   (              )                                                (           )
 Day Phone Number                                               Evening Phone Number


 E-Mail Address



                                                                                    Vice-President
 Name                                                                               Office Title


 Mailing Address                                                Town                                              State            Zip Code
   (              )                                                (           )
 Day Phone Number                                               Evening Phone Number


 E-Mail Address



                                                                                    Treasurer
 Name                                                                               Office Title


 Mailing Address                                                Town                                              State            Zip Code
   (              )                                                (           )
 Day Phone Number                                               Evening Phone Number


 E-Mail Address



                                                                                    Secretary
 Name                                                                               Office Title


 Mailing Address                                                Town                                              State            Zip Code
   (              )                                                (           )
 Day Phone Number                                               Evening Phone Number


 E-Mail Address



                                                                                         Mgmt. Agent
                                                                                         Mgmt. Agent                    Other:
 Name                                                                               Please check one , if Other give title


 Mailing Address                                                Town                                              State            Zip Code
   (              )                                                (           )
 Day Phone Number                                               Evening Phone Number


 E-Mail Address



                                                                                         Accountant
                                                                                         Mgmt. Agent                    Other:
 Name                                                                               Please check one , if Other give title


 Mailing Address                                                Town                                              State            Zip Code
   (              )                                                (           )
 Day Phone Number                                               Evening Phone Number


 E-Mail Address




 Meeting Schedule                                                                                                 Annual Meeting Date



SHP Form 10-4 d90e9fb5-d93b-48f9-8910-9a33223c7d33.xls
REV. 2/09