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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.                       PEST CONTROL

60. Pest Control Company*
61. Phone Number*
63. Address*
65. City*
66. State*
67. Zip Code*
69. Frequency Schedule*
72. TENANT INFORMATION
74. List name of each primary or principal tenant over the age of 18(a copy of the lease must also be submitted with application)
76. 1
77. 2
78. 3
79. 4
81. 5
82. 6
84. Home Phone
85. Business Phone
86. Mobile Phone *
88. Email Address
90. Number of Adults*
91. Number of Children*
92. Total Number of Persons Occupying Rental Unit*
94. Pets*
    -- Select One --YesNo
95. Lease Expiration Date*
    Lease Expiration Date
99. Tenant Vehicle Information
101. License Plate #
102. Year
103. Make and Model
104. Color
106. License Plate #
107. Year
108. Make and Model
109. Color
111. License Plate #
112. Year
113. Make and Model
114. Color
116. License Plate #
117. Year
118. Make and Model
119. Color
121. License Plate #
122. Year
123. Make and Model
124. Color

128. 8.07.040–Additional rental requirements andrestrictions.

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

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

130. 

132. Maximum number ofoccupanciesfor bedrooms must also comply with the square footage requirements noted in Section 404.4.1 of theProperty Maintenance Code.

     Municipal Code15.24.060–Basement rooms.

     No basement room shall be used as a sleeping room.

     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 located within fifteen feet (15’) from all sleeping roomsand on each level.If youhave any questions regarding detectors, please contact the Fire Department at (708) 447-1981

134. 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.
136. All of the information provided in the Application is true and correct to the best of my knowledge:
138. Electronic Signature*
Leave This Blank:


140. 1. Receive an email copy of this form.
141. Email address

     This field is not part of the form submission.

142. Submit

* indicates a required field