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Email *

First Renewal

Fee Schedule

Fee Due

City *

Second Renewal

Each Subsequent Renewal

State *

Email *

Initial Fee

Maintenance Company *

ZIP *

$1500.00

Unit #

Property Address

Phone #

Address *

Lot

Property Details

Specify the Address *

Insurance Details

City, State, ZIP *

City

Insurance Company

$5000.00

Township of
Moorestown

$ 500.00

Phone # *

Utilities

111 W 2nd Street
Moorestown, NJ 08057
856-235-0912
www.moorestown.nj.us

ZIP

Phone # *

Gas Company *

Property Location

Address *

Email *

City *

Phone # *

$3000.00

Maintenance Provide Details

Attachments

ZIP *

Agent Name *

Vacant Property
Registration

Mailing Street *

Applicant Signature *

Owner of Record *

Block

Registration Type *

Account # *

Qualifier

Phone # *

State

Address

State *

Owner of Record Details

Phone # *

Account # *

Electricity Company *

Date Property Became Vacant *

Agent Details