Rental Registration Removal

2. Rental property type*
   -- Select One --Single-familyTownhouseDuplexApartment
4. Rental property address*
5. Number of units*
7. Property Owner name*
8. Property Owner email*
10. Property Owner phone number*
11. Property Owner street address, city, state, ZIP code*
13. Reason for removal from rental registration list and map*
15. Requested date for property to be removed from rental registration list and map*
    Requested date for property to be removed from rental registration list and map
17. I verify that:*

    1. All information that I have provided is true and accurate to the best of my knowledge.
19. Name of person completing this form*
20. Date*
    Date
Leave This Blank:


21. 1. Receive an email copy of this form.
22. Email address

    This field is not part of the form submission.

23. Submit

* indicates a required field