City of Burlington, Vermont

191-195 Bank St

First Name

Last name

Email Address

Phone Number

Your Relationship to the Property

I attest that I am either: The owner of the property. A lawyer, paralegal or assistant, an employee or agent of a financial institution as that term is defined in 8 V.S.A. §11101, an employee or agent of a credit union as that term is defined in 8 V.S.A. §30101, a realtor, or a certified public accountant as that term is defined in 26 V.S.A. §13(12) who represents that he or she has a need for the information as it pertains to a real estate transaction or to a client or customer relationship.