Type Full Name :
Sign With Hand
Address *
Does the Owner have a local agent? If "Yes" please fill out the section below.
City, State, ZIP *
Owner Information
If the Owner is NOT a resident of Morris County, a local agent MUST be designated as a contact person
Water
1001 Parsippany Boulevard
Parsippany-Troy Hills, NJ 07054
(973) 263-4280
www.parsippany.net
If Fuel Oil is used at this property then provide details of the fuel oil provider
Block
Phone *
Utility Information
Oil
Electric
Is Fuel Oil Used at this Property? *
Township of
Parsippany-Troy Hills
Complete Name *
Landlord
Registration
Phone *
Is the Emergency Contact person the same as Owner above? If "No" please fill out the section below.
Number of Units Leased *
Fuel Oil Information
Complete Name *
Applicant Signature *
City, State, ZIP *
Address *
Emergency Contact Information
Please type in the address below for which you are applying for the Landlord Registration
Address *
Address *
Gas
Phone *
City, State, ZIP *
Lot
Property Type *
Email *
Provide details for an emergency contact person for the property. The emergency contact person must be local and authorized to act or perform work in the event of an emergency.
City, State, ZIP *
Agent Information
Complete Name *
Address *
Complete Name *
Number of Units Owned *
Property Information
Specify which of the following utilities are provided at this property by the Owner (select all that apply)