Rental Unit Registration Form - City Of Akron Department Of Public Service - 2010
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4DEPT. OF PUBLIC SERVICE
___OFFICE USE ONLY___
CUSTOMER SERVICE/HOUSING DIVISION
146 S. HIGH ST, SUITE 700
Amt. Rec’d _______________
AKRON, OH 44308
(330) 375-2366 ♦ FAX: (330)375-2328
Check/MO#_______________
RENTAL UNIT REGISTRATION FORM
Date_____________________
Section I: Owner(s) Required
Owner ID#________________
Owner refers to person or persons with legal title
Please √ type of owner: Individual ( ), Sole Proprietorship ( ), Partnership ( ), Corp. ( ), Trust ( ), Other ( )
Owner’s Name: ___________________________________________________________________________
Owner’s Address: ___
City:_
State:______
Zip Code:
_
Phone #: (
)
E-Mail Address: _______________________
Tax ID# of corporation or partnership: __________________
If the owner is a partnership, corporation or trust, complete the following for one partner, officer or
trustee:
Name and Title: __________________________________________________________________________
Address: _________________________________________
City: _____________________ State: _____
Zip Code: ____________
Phone #: (
)____________
E-Mail Address: _______________________
Section II: Complete only if the owner uses the services of an operator or contact person
(This is mandatory if the owner lives outside Summit County or an adjacent county)
Name of operator or contact person: __________________________________________________________
Address: __________________________________________ City: ______________________ State: _____
Zip Code: _____________
Phone#: (_____)____________
E-Mail Address: ________________________
If the operator is a partnership, corporation or trust, complete the following for one partner, officer or
trustee:
Name & Title: ____________________________________________________________________________
Address: _________________________________________ City: _______________________ State: _____
Zip Code: ____________
Phone#: (_____)____________ E-Mail Address: _________________________
Tax ID# of corporation or partnership: ___________________
The following fees apply for the total number of units owned:
1 Unit - $ 15.00
:
Make checks payable to
2-5 Units - $ 25.00
City of Akron
6-25 Units - $ 75.00
Dept of Public Service
26-100 Units - $150.00
Customer Service/Housing Div.
101 or More - $250.00
146 S. High St., Ste. 700
Late Registration Fee - $10.00 (if paid after January 15)
Akron, OH 44308
Revised 2/22/10
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