Print this page, fill out the form and mail it to:
Mr. Ross Aranda • 1419 Crescent Dr. NW • Albuquerque, NM 87105
Telephone: (505) 831-6529 • www.AtriscoHeirs.org
Or send your information in an email to: egarcia@AtriscoHeirs.org

Please send me information about Concerned Heirs of Atrisco.

Name: _____________________________________   
If you are a Westland Shareholder please print your name as it appears on your stock certificate

Mailing Address:

Street: _____________________________________

City: ________________________, State: ______, Zip: ________________

Telephone: (           ) __________________________

Email Address: ________________________ @ _______________________

c Atrisco Heir  c Westland Shareholder/ ________ Number of Shares

Help us contact other heirs: Please tell us of other heirs or shareholders that you know and how we may contact them. Or give them a copy of this form so that they may send for information. Thank you.

It is the policy of the Concerned Heirs of Atrisco that all contact information shall remain in the possession of this organization and shall not be used for any purpose other than those needed for communication with the provider and within the Concerned Heirs of Atrisco organization or its assignees. Nor shall any  information submitted be disclosed to any outside party, except as may be required by law.