Village Grande at English Mill Homeowners Association 
                                                          FORM 103 
                                        DEPOSIT OF FUNDS FORM 
                                       (Return by Email, fax or place in Mailbox outside Site Manager’s Office) 
        I,  ______________________________________ hereby submit funds in the amount of $ ___________ to the VGEM 
        HOA as follows: 
        Source of Funds: _________________________________________________________________________ 
         Cash                               
         Checks (List by Name & No.)        
                                            
                                            
                                            
                                            
                                            
                                            
                                            
                                            
                                            
         Total                              
         
        Comments: 
        __________________________________________________________________________________________________ 
         
         
        Date Received: ____________  By: _____________________________________________ 
        Please keep a copy of this form as your receipt.   
         
        (For use of HOA only) 
        Acct. Credited: ________________        By: __________         Deposit Date: __________        By: _____________ 
        8-26-2013