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Annual Certification of Property Registration Information – Confirm Property
Annual Certification of Property Registration Information – Confirm Property
REQUEST SUMMARY
Request Type
*
Initial
Transfer
Amend
Update
Recertification
Request Date
*
*
Requestor
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Modify Exisiting Building/Units?
Modify Exisiting Building/Units?
No
Modify Exisiting Building/Units?
Yes
CURRENT PROPERTY INFORMATION
Property Name
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PROPERTY SUMMARY
Property Name
*
Property Type
Bed and Breakfast
Condominium
Retreat Lodging Facility
Private Dormitory
Exempt Townhouse Fee Simple
Hotel
Motel
Multiple Dwelling
Retirement Community
Rooming or Boarding
Social Service Hotel
Public Housing Authority
Proprietary Campgrounds
Ownership Type
Condominium Association
Cooperative
Government Agency
Corporation
County
Federal
General Partnership
Individual/Sole Proprietorship
Limited Liability Company (LLC)
Limited Liability Partnership (LLP)
Montclair State University
Municipal
Mutual Housing Corporation
Legal Partnership
Port Authority
Public Housing Authority
Rutgers University
State
Non-Profit
Estate of
Date Purchased
*
County
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Municipality
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Request Attributes
Seasonal Property?
Seasonal Property?
No
Seasonal Property?
Yes
Is Property Controlled By Net Lease Or Other?
Is Property Controlled By Net Lease Or Other?
No
Is Property Controlled By Net Lease Or Other?
Yes
Is There A Mortgage Held On This Property?
Is There A Mortgage Held On This Property?
No
Is There A Mortgage Held On This Property?
Yes
Is Property Heated By Fuel Oil?
Is Property Heated By Fuel Oil?
No
Is Property Heated By Fuel Oil?
Yes
Does This Property Have 9 or More Units?
Does This Property Have 9 or More Units?
No
Does This Property Have 9 or More Units?
Yes
Primary Owner
NAME
First Name
*
Middle Name
*
Last Name
*
Organization/Agency Name
*
FEIN#
*
NJ Corporate Registration #
*
CONTACT
Business Phone
*
Mobile Phone
*
Email
*
*
Electronic Contact Disclaimer Accepted?
PRIMARY ADDRESS
Address Line 1
*
Address Line 2
*
Address Line 3
*
City
*
State/Providence
*
Zip/Postal Code
*
Country/Region
United States of America
Canada
Authorized Agent
Is the Authorized Agent the Same As Primary Property Owner?
Is the Authorized Agent the Same As Primary Property Owner?
No
Is the Authorized Agent the Same As Primary Property Owner?
Yes
NAME
Organization/Agency Name
*
First Name
*
Middle Name
*
Last Name
*
CONTACT
Business Phone
*
Mobile Phone
*
Email
*
*
Electronic Contact Disclaimer Accepted?
ADDRESS
Address Line 1
*
Address Line 2
*
Address Line 3
*
City
*
State/Providence
*
Zip/Postal Code
*
Country/Region
United States of America
Canada
REQUESTER COMMENTS
*
ATTACHMENTS
