Address to be removed from the rental housing records

 *

(one address per entry -up to 100 characters)

Date of Removal

Date of Removal

Number of units to be removed

 *

Number of units to be removed

All

One

Two

Other If other, type text here.

Property Owner Information

 *

Property Owner Information

First Name	Last Name	Company Name
Owner's Email	Address	City
State	Zip	Phone
Cell Phone

Property Manager information is exactly the same as Property Owner

 *

Property Manager information is exactly the same as Property Owner

Yes

No

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