2. Owner/Corporation Name*
4. Mailing Address*
5. City*
7. State*
8. Zip Code*
10. TD Parcel*
11. Property Class
13. Property Address*
14. City*
16. State*
17. Zip*
19. IF PROPERTY IS RENTED, THE NON EXHAUSTIVE LIST BELOW DOES NOT APPLY. COMPLETE THE RENTAL REGISTRATION.
21. Reason for Exception*
    -- Select One --Primary Residence (Owner Occupied)Secondary residenceFamily member lives in home (no rent is charged)Property is currently listed for saleProperty is vacantOther

    Please explain below the reason the property in question does not qualify for either the Rental Registration program or the Owner Occupied tax reduction

23. Other Explanation*
    Please detail reason for Other exception.
25. Agreement*

    1. I Agree

    I declare under penalty of perjury that this statement to the best of my knowledge and belief is a true and complete statement.
27. Signature*
28. Date*
30. Phone Number*
31. Email Address*
Leave This Blank:


33. 1. Receive an email copy of this form.
34. Email address

    This field is not part of the form submission.

35. Submit

* indicates a required field