New Registered Denied

Yes No

Yes No

Yes No

Property Owner Corporation Managing Agent Responsible Person Other

Yes No

Yes No

Yes No

Yes No

Yes No

Yes No

Yes No

Air Conditioning *

Off Street Parking/Garage

Please enter Maintenance Provider Details. *

Phone *

Address

Email

State *

Apartment Details

Signature

Last Name *

Please specify other services provided and/or other pertinent information, if applicable.

Email *

Phone

Email

Address

Phone

Responsible Person Details

Please attach required documents (ex. rent roll). Please note files cannot exceed 25 MB. *

Name

Email

Each Additional Charge

Address

First Name *

Please enter Apartment and Rent details. *

Tenant Electric *

ZIP *

Begin typing address and select from the populated dropdown *

Address *

Total # Rental Units *

Maintenance Provider Details

Is your Property Registered with the NJDCA for Lead?

Services and Utilities

Business Name

State *

Applicant Signature *

Name

Owner is Corporation?

State

Phone

Building Owner Details

Interior Maintenance *

Emergency Contact Details

Cooking Fuel *

Off Street Parking *

Heat *

City *

Exterior Maintenance *

Building Details

Address 2

Email

Address *

If off street parking is charged, the following must be answered. *

ZIP *

Registered Agent Details

Address

Zip

Phone

Name

(Authorized to accept notices from a tenant, to issue receipts for those notices and to accept service of process on behalf of the out of county record owner)

Owner is located in the same county in which Dwelling is located?

Attachments

Managing Agent Details

City

2024 Allowable Base Rent Increase Cannot Exceed 3%; Can only be increased once during every 12 months.

*NOTE: If your lease is month-to-month, you must still provide this office with a “lease start date”. If additional space is needed, please provide a separate attachment with all the above referenced specifications for each apartment.

The filing of the Rental Registration Form does not constitute a determination by the Rent Control Board of the rent increase recorded by the landlord on this statement Failure to register residential rental properties will result in a disorderly person's violation and summonses being issued subject to penalties under Section 5.70.230 of the City of Elizabeth’s Rent Control Ordinance.

This document is a government record within the meaning of the New Jersey Open Public Records Act (OPRA), N.J.S.A. 47:1 A-1 et seq. Pursuant to OPRA all government records shall be subject to public access unless exempt from such access. Exempt information includes personal telephone numbers, email addresses and home addresses of persons covered under Daniels Law, NJ.SA. 47:1-17. If you or any person listed on this form has sought and received approval from the New Jersey office of Information Privacy and is now deemed to be a covered person pursuant to Daniel’s Law kindly advise.

 

I certify under penalty of law that the information provided in this document is true and accurate.

 

Emergency Contact Is

Phone

One Car

Corporation Details

Email

Name

City *

Address