By completing this form, you are declaring the below statements are true and accurate. You further acknowledge that making a false, fictitious, or fraudulent statement or representation in this sworn affidavit is punishable under the criminal laws of Colorado as perjury.

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* 1. Full Name

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* 2. Unit Address

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* 3. Contact and Mailing Address Owner

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* 4. Do you have roommates (besides a co-owner and/or children)?

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* 5. Do you reside full-time in the deed-restricted home for 9 months or more per year?

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* 6. Are you employed 1,500 hours or more per year in Pitkin County (for a business that serves Pitkin County residents)?

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* 7. Is this property the only residence you own in the Ownership Exclusion Zone (the land area in which is located any developed residential property that has an address within the Roaring Fork Drainage situated in Eagle, Pitkin, Garfield, or Gunnison Counties, or within the Colorado River Drainage from and including the unincorporated No Name area to and including Rifle, and including but not limited to, the incorporated areas of Aspen, Basalt, Carbondale, El Jebel, Glenwood Springs, Marble, Meredith, New Castle, No Name, Redstone, Rifle, Snowmass, Snowmass Village, and Woody Creek)?

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* 8. Are you the sole owner of the property? (i.e. the only name on the title)

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* 9. If no, please provide Contact Information for the Second Owner

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* 10. Does the second owner reside full-time in the deed-restricted home for 9 months or more per year?

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* 11. Is the second owner employed 1,500 hours or more per year in Pitkin County (for a business that serves Pitkin County residents)

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* 12. Is this property the only residence the second owner owns in the Ownership Exclusion Zone (the land area in which is located any developed residential property that has an address within the Roaring Fork Drainage situated in Eagle, Pitkin, Garfield, or Gunnison Counties, or within the Colorado River Drainage from and including the unincorporated No Name area to and including Rifle, and including but not limited to, the incorporated areas of Aspen, Basalt, Carbondale, El Jebel, Glenwood Springs, Marble, Meredith, New Castle, No Name, Redstone, Rifle, Snowmass, Snowmass Village, and Woody Creek)?

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