Unit Owner Name:  

Address:  

Telephone Number Home:  Telephone Number Work:  

Email Address:  

Tenant Name:    Tenant Name:  

Tenant Phone Number: Tenant Phone Number:  

IF your unit is rented, you must provide management a copy of your lease in order to obtain a parking permit.  Each unit is issued only one (1) permit (hangtag).  Parking permits may only be obtained by the unit owner or the owner's designated real estate/leasing agent.  It is the owner's responsibility to provide their parking permit and copy of the rules and regulations of the Association to their tenants/residents.  Promptly report lost or stone tags; a replacement permit is available for a fee (per Association rules).

Vehicle #1:

Make: Model: Year: Color: License Plate Number & State (note: must be a Va. license plate as required by applicable law - exempts active duty military):  

Vehicle #2:

Make: Model: Year: Color: License Plate Number & State (note: must be a Va. license plate as required by applicable law - exempts active duty military):  

Please pay for the permit online through your resident portal using the instructions below. https://CentrevilleCrossingCondos.connectresident.com

Instructions for making resident portal access device payments: Once logged in, click 'Make A Payment' to access ClickPay. As the charge may not yet appear on your account, select the 'Edit' button next to the balance, then select 'Alternative Amount' to manually enter the fob payment amount. See the attached payment screenshot example as well.  If you have trouble making a payment through the resident portal please call 24/7 Customer Care Center so they can walk you through it step by step over the phone at 800.870.0010.

By signing this form, I/we attest that I/we have read and understand the Centreville Crossing Homeowners Assocation Policy Resolution No. 1 (Vehicle & Parking Policies), and that I/we will receive one (1) hangtag. 

Printed Name: