Survey/Form Review
Residential Rental Building Registry
Type of registration:*

Section 1
OWNER INFORMATION

Name
Full Legal Name
Title
Owner's Address (Not Rental Property Address)
Full Street Address
City
State
ZIP
+4
Contact Information
Work Phone
Email
Property Owner Business Type
if other, explain:

Section 2
PROPERTY AGENT / OPERATOR / MANAGER INFORMATION

If you use a property management company, please enter their information in this section. If not, please continue on to Section 3.

Management Name
Company Name
Agent / Manager Full Legal Name
Address
Street
City
State
ZIP
+4
Contact Information
Work Phone
Work Cell Phone
Emergency Phone
Email (Leave blank if none)

Section 3
RESIDENTIAL RENTAL BUILDING / DWELLING INFORMATION (Enter 1 Address per Building Number)

Buildings
Full Street Address-Zip CodeNumber of Dwelling Units Per Building
Building 1
Building 2
Building 3
Building 4
Building 5
Building 6
Building 7
Building 8
Building 9
Building 10
Building 11
Building 12
Building 13
Building 14
Building 15
Building 16
Building 17
Building 18
Building 19
Building 20
Building 21
Building 22
Building 23
Building 24
Building 25
Building 26
Building 27
Building 28
Building 29
Building 30
Building 31
Building 32
Building 33
Building 34
Building 35
Building 36
Building 37
Building 38
Building 39
Building 40
Building 41
Building 42

 
http://evansville.in.gov/index.aspx?recordid=174&page=1682