Form Center

2. 
4. Building Address*

                                                                                               OWNERSHIP INFORMATION

6. Owner Name*
8. Street Address (P.O. Box not acceptable)*
10. City*
11. State*
12. Zip Code*
14. Home Phone
15. Business Phone
17. Mobile Phone
18. Email Address
20. PLEASE NOTE: If e-mail address is provided, license and renewal paperwork WILL be e-mailed.
22. Driver’s License #*
24. Has there been achange of ownership or an additional tenant of the rental unit since last registration date?*
27. PROPERTY MANAGER INFORMATION–NOT YOUR ASSOCIATION
29. Property Manager*
31. Street Address (P.O. Box not acceptable)*
33. City*
34. State*
35. Zip Code*
37. Business Phone
38. Mobile Phone
40. Email Address
42. Do you want all correspondence and mailings to go to property manager?*

    1. Yes
    2. No
45. EMERGENCY CONTACT INFORMATION
47. Emergency Contact Name*
49. Street Address (P.O. Box not acceptable)*
51. City*
52. State*
53. Zip Code*
55. 24 Hour Emergency Phone*

58.       GARBAGE AND PEST CONTROL

60. Garbage Company*
62. Address*
63. Phone Number*
65. Service Days*
    -- Select One --MondayTuesdayWednesday Thursday Friday
67. Knox Box Installed on Exterior of Building:*

    1. Yes
    2. No
71. Pest Control Company*
72. Phone Number*
74. Address*
76. Frequency Schedule*
78. TENANT INFORMATION
82. Tenant Name
83. Unit #
84. Contact #
86. License plate #
87. Year
88. Make
90. Model
91. Color
95. Tenant Name
96. Unit #
97. Contact #
99. License plate #
100. Year
101. Make
103. Model
104. Color
108. Tenant Name
109. Unit #
110. Contact #
112. License plate #
113. Year
114. Make
116. Model
117. Color
121. Tenant Name
122. Unit #
123. Contact #
125. License plate #
126. Year
127. Make
129. Model
130. Color
134. Tenant Name
135. Unit #
136. Contact #
138. License plate #
139. Year
140. Make
142. Model
143. Color
147. Tenant Name
148. Unit #
149. Contact #
151. License plate #
152. Year
153. Make
155. Model
156. Color
160. Tenant Name
161. Unit #
162. Contact #
164. License plate #
165. Year
166. Make
168. Model
169. Color

173. 8.07.040–Additional rental requirements and restrictions.

     A. No owner shall rent a unitor allow a person to occupy any dwelling or dwelling unit unless it is clean, safe, sanitary, fit for human occupancyand complies with all applicable codes, ordinances, and regulations of the Village.

     B. No owner shall permit the total number of occupants of any dwelling or dwelling unit to exceed the maximum occupancy permitted as statedbelow.

175. 

177. State law requires installation and maintenance of smoke detectors for all rental units, one within each bedroom and one on each level of a multiplelevel dwelling.State law requires that carbon monoxide detectors be locatedwithin fifteen feet (15’) from all sleeping rooms.If you have anyquestions regarding detectors, please contact the Fire Department at (708) 447-1981

179. 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.

     1. I agree.

181. All of the information provided in the Application is true and correct to the best of my knowledge:

183. Electronic Signature*
Leave This Blank:


185. 1. Receive an email copy of this form.
186. Email address

     This field is not part of the form submission.

187. Submit

* indicates a required field