Type Full Name :
Sign With Hand
Attachments
Email *
Water
Agent Name
Address
Status *
Parcel ID *
Property Identified As
City, State, ZIP
Property Owner Information
Phone #
City, State, ZIP
I, the undersigned, hereby affirm that i am duly authorized to act on behalf of all ownership interests in the above-referenced property. I hereby attest/swear that the information contained herein is accurate and complete to the best of my knowledge. I am aware that if any of the foregoing statements made by me are willfully false, I am subject to punishment under the violations section of §132-91.le.
Property Type *
If the owner resides outside a 35 mile radius from LaSalle, you must designate a local Agent (within 35 miles of LaSalle) to accept property maintenance and notice/service responsibility. (P.O. Box Not Acceptable).
Number of Stories
Name
Property For Sale/Lease by Owner
Balance Remaining
Email *
{[PNAME]}
Property Details
{[ADDR]}
{[CITY]}, {[STATE]} {[ZIP]}
{[APHONE]}
{[AWEBSITE]}
Phone Number
Company Name
Account Number
Certification
Fee Schedule
Assessment
Fee Total
Applicant Signature *
Address
Number of Garages
Financial Institution/Bank Information
City, State, ZIP *
Gas
Registration Fee
Address *
Email
City, State, ZIP *
Company Name
Phone # *
Email
Company Name
Representative *
Mailing Address *
Name *
Agent/Representative
Property Address
Address *
Unit #
Utilities
Phone #
Registration Type *
Phone # *
Maintenance Company

New Registration

  • $300 - Less than 20,000 Square Feet 
  • $600 - More than 20,000 Square Feet

Renewals

  • $500 - Less than 20,000 Square Feet
  • $1,000 - More than 20,000 Square Feet

Initial and any subsequent registrations shall be valid for a period of 3 months.

Contact Agent
Electric
Square Footage *