Owner Withdrawal Form

Question Title

* Owner Name

Question Title

* Owner Number

Question Title

* Today's Date

I am an owner of the Lexington Co-op and wish to withdraw my ownership and redeem my equity share in the Co-op. I understand that I will no longer enjoy the benefits of ownership from the date that my ownership share is refunded.

I also understand that redemption proceeds shall be subject to be offset by amounts due and payable to the Co-op by the owner.

Question Title

* Amount paid toward owner share:

$20

$40

$60

$80

Other (We will verify the amount from our records)

Question Title

* Please send my refund to the following address:

Address *

Address 2

City/Town *

State/Province *

ZIP/Postal Code *

Phone Number *

Question Title

* Email

Question Title

* Why are you withdrawing your co-op ownership?

I no longer shop at the co-op.

I am moving out of the area.

I am dissatisfied with the co-op.

Other

Although the Co-op is not required to refund equity within a certain time period, in general you can expect your refund within 60 days of your request. If you have any questions or need further assistance, please contact us at 716-886-1036.