Type Full Name :
Sign With Hand
Parking Meter Rental Application
123 Main Ave
123, Main Street
Number of Days Required
Location of Meter(s) to be Rented
Your Town
Include a stamped self-addressed envelope with your check.
State*
$10.00 per meter per day
Organization Name (if applicable)
Payment can be made by Cash, Check, Money Order or Credit Card, in person.
Your Town
Meter Rental Details
Fee Due
You can also find it in the email responder to this application.
Email*
Telephone #*
City*
Fee Schedule
Address*
Please note: The signs must be placed on the meters 24 hours in advance of the date needed.
First Name*
Your Town, USA 00000
I agree that the Your Town Parking Utility, it employees, as well as Your Town, shall not be liable to me, my guests, or property damage is causes by negligence, action, and/or inactions of the Montclair Parking Utility, its employees, or the Township of Montclair. I agree to hold the Your Town Parking Utility, its employees, and Your Town harmless for any such claims.
* Indicates required field
Meter #(s)
Your Town,NJ 00000
Applicant Signature
Alternatively, a Check or Money Order can be mailed to us at the address below. Please do not mail Cash, this form of payment will not be accepted.
Date From
All Other Reasons
Zip*
Applicant Details
(555) 555-5555
Include your application reference number on all checks. Your reference number will be displayed upon submission of this application.
www.yourtown.us
$20.00 per meter per day
Number of Meters Required
Purpose of Rental
Last Name*
Moving In or Out of Town