Please check one or both: ____ Sierra Park Water Company, Inc. ____________________________ appears on the refund check Print name as it ____ Odd Fellows Sierra Recreation Asso. ____________________________ appears on the refund check Print name as it I understand this request is irrevocable. Thank you, ____________________________ appears on the Sierra Park Water Company, Inc. refund check Sign name as it ____________________________ appears on the Odd Fellows Sierra Recreation Association refund check Sign name as it (End of Appendix A)
Please check one or both: ____ Sierra Park Water Company, Inc. ____________________________ Print name as it appears on the refund check ____ Odd Fellows Sierra Recreation Asso. ____________________________ Print name as it appears on the refund check I understand this request is irrevocable. Thank you, ____________________________ Sign name as it appears on the Sierra Park Water Company, Inc. refund check ____________________________ Sign name as it appears on the Odd Fellows Sierra Recreation Association refund check (End of Appendix A)
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