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Landlord Registration
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{[ADDR]}
{[CITY]}, {[STATE]} {[ZIP]}
{[APHONE]}
{[AWEBSITE]}
Property
Contacts
Certification
Single Family
Detached Unit
Apartment
Commercial
Duplex
Condo
Two Family
Mobile Home
Twin
Other
No
Yes
No
Yes
No
Yes
No
Yes
No
Yes
No
Yes
CCO Obtained?
Move in Date
Is Dwelling Vacant?
Oil
Block
Specify which of the following utilities are provided at this property by the Property Owner.
Water
Building Name(s)
Zone
Lock Box #
Utilities
Electric
Lot
Property Type
# of Bedrooms
Lockbox Location
Total # of Buildings on Property
If Other
Sewer
Gas
Property Details
# of Dwelling Units
Address
Corporation
Individual
Partnership
Other
Yes
No
Owner
Realtor
Other
Electric
Gas
Fuel Oil
Address
Type
City, State, ZIP
Email
Managing Agent Details
Emergency Contact Person Is
If needed you can add additional emergency contacts
Heating Dealer Address
Email
Name
Name
Heating Dealer Name
Property Owner
Email
Type
Name
Mailing Address
Realtor Details
Mortgage Holder Details
Phone #
Emergency Contact Address
Disclaimer: If a Tenant is a minor, you must specify their age.
Tenant Details
Heating Details
Heating Dealer Phone #
Name
Phone #
Maintenance Provider Details
Phone #
Additional Owner Details
Business Name
Registered Agent Details
Email
Address
Address
Phone #
City, State, ZIP
If no, please provide the party responsible for accepting notices from tenants & their address
Does the owner reside in the county?
Name
Phone #
Emergency Contact
Email
Heating Grade
Submit
Type Full Name :
Sign With Hand
Clear
Done
Attachments
Application Fee is 75$
Please submit a CCO if acquired before filing. This is not required at time of submission but is encouraged.
Please attach Certificate of Insurance & see
law S-1368
.
Certification
N.J.A.C. 5:29-1.1
5:29-1.1 Applicability
(a) Pursuant to N.J.S.A. 46:8-28 and 46:8-29, the form prescribed by this subchapter is required to be given by landlords to tenants in single unit dwellings and in two – unit dwellings that are not owner-occupied and to be filed in the office of the clerk of the municipality in which any such single unit dwelling or two-unit dwelling is situated.
(b) Tenants in multiple dwellings are required to be given a copy of the certificate of registration filed with the Bureau of Housing Inspection in accordance with N.J.S.A. 55:13A-12, N.J.S.A. 46:8-28 and N.J.A.C. 5:10-1.11. (Contact the Bureau of Housing Inspection, P.O. Box 810, Trenton, New Jersey 08625 (609) 633-6240 for registration applications for buildings with three or more dwelling units).
Please click
here
to view all the required filings, violations, and penalties.
Application Fee
*Payment will be requested following application review. Please be advised that In order to receive a license all payments should be made to the Borough of Leonia.
Fee
Applicant Signature
Female
Male
Age
Tenant Details
Monthly Rent
Unit
Last Name
First Name
Gender
Building
Save
Cancel
Email
Additional Owner Details
ZIP
City
Address
Phone
State
Name
Save
Cancel
Owner
Realtor
Phone #
Emergency Contact Person Is
Address
Name
Email
Additional Emergency Contacts Details
Save
Cancel
Email
Phone
Name
Address
ZIP
City
State
Mortgage Holders Details
Save
Cancel
Superintendent
Janitor
Custodian
Other
Type
Maintenance Providers Details
Address
Name
Type Other
Phone
Save
Cancel
Date Entered:
Your application has been submitted successfully.
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