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Landlord Registration Form

  1. Is The Record Owner A Corporation?*
  2. Does the record owner(s) live in the county?*
  3. Is there a managing agent?*
  4. Is there a superintendent, janitor, custodian, or other person employed to provide regular maintenance service?*
  5. Is there a recorded mortgage on the property?*
  6. Is the building heated by fuel oil and the landlord furnishes heat?
  7. The name, address, and telephone number of an individual representative of the record owner or managing agent who may be reached or contacted at any time in the event of an emergency affecting the dwelling or any dwelling unit, including such emergencies as the failure of any essential service or system, and who has authority to make emergency decisions concerning the building, including the making of repairs and expenditures, is as follows: 

  8. Electronic Signature Agreement*

    By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.

  9. Would you like a confirmation of receipt?*
  10. Leave This Blank:

  11. This field is not part of the form submission.