WINGFOOT CONDOMINIUM ASSOCIATION



Unit #___________________ Wingfoot Dr. Jupiter Florida, 33458

Owner/Occupant_______________________________________
                         ( Please Print)

Owner/Occupant_______________________________________
                         ( Please Print)
This certifies that one or both of the above occupants are over the age of 55 years old. 
Signed__________________________________________________Date______________20_____
                        (Owner)
This survey is necessary to maintain compliance with the Housing for Older Persons Act of 1995 and Housing and Urban Development requirements.

Please provide a copy of the Driver's License.

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