Victory Heights County Road Maintenance District

Owner Survey Form

xxx TRUST

P.O. BOX xxx

Pinedale, AZ 85934

Parcel Number: 205-31-xxxx

The results of this survey will determine whether or not we proceed with the formation of a Victory Heights Count Road Maintenance District (MD) to support the maintenance of our Victory Heights roads. We will proceed only if a majority of the owners or the owners of a majority of the property support the formation of the MD.

We would very much appreciate your completing this survey, and mailing it to us using the enclosed self-addressed envelope no later than January 15, 2006. Thank you very much for helping us with this effort.

Note: Some of you own multiple parcels, and you have been provided a survey form for each parcel. If your response is the same for all parcels, you need only complete a single survey form, and list the additional parcel numbers, to which the survey response applies, following the parcel number shown above.

Survey Questions

1. Based on the information we have supplied, would you support the formation of a Victory Heights County Road Maintenance District for the maintenance of our roads?
   □ YES
   □ NO
2. If NO, please tell us why. Is there any way we could change the proposal to make it acceptable to you?
   
   
   
   
3. Do you feel that you have been included in this proposed MD in error? For example, you have direct access to Highway 260 without using the Victory Heights roads.
   □ YES
   □ NO
4. If YES, please tell us why.
   
   
   
   
5. There will be costs incurred during the process of forming the MD. For example, we will need to provide a survey of the MD boundaries. If you are in favor of forming the MD, would you be willing to contribute to help offset these costs?
   □ YES
   □ NO
6. Please provide any comments and suggestions you feel might be helpful to us