Rental Dwelling (Boardwalk) Form submitted by: * Email * Phone * Property Owner(s) Information Legal Name * Legal Name First First Last Last Does this individual go by a different name? (e.g. nickname) * No If Yes, please enter:If Yes, please enter: Relationship to Primary Property Owner: * Self Spouse Other – please enter:Other – please enter: plus1 Add Additional Property Owner minus1 Remove Primary Property Owner’s Date of Birth * This should be the first person listed above. Primary Property Owner’s Email Primary Property Owner’s Phone * Is the title holder different than the property owner? (e.g. a trust or business holds the title.) * No If Yes, please enter:If Yes, please enter: Primary Property Owner’s Mailing Address * Primary Property Owner's Mailing Address Primary Property Owner's Mailing Address Primary Property Owner's Mailing Address City City State/Province State/Province Zip/Postal Zip/Postal Country AfghanistanAland IslandsAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBruneiBulgariaBurkina FasoBurundiCôte d'IvoireCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos (Keeling) IslandsColombiaComorosCongoCook IslandsCosta RicaCroatiaCubaCuracaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFalkland Islands (Malvinas)Faroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestinePanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarReunionRomaniaRussiaRwandaSaint BarthelemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint Martin (French part)Saint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint Maarten (Dutch part)SlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUnited States Minor Outlying IslandsUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabwe Country How many rental properties does the primary property owner own? Insured Location Address * If available, please drop current insurance document here or click to upload Choose File Maximum file size: 10MB Requested effective date? * Year Built * Square Footage? * Foundation Type * SlabBasementCrawl SpacePilings/StiltsHillside FoundationOther Roof Update Year Electrical Update Year Plumbing Update Year AC Update Year Heating Update Year Water Heater Update Year Type of Garage? * None Attached Detached Carport Number of Garage Stalls Any detached structures (other than garage, if applicable)? E.g. storage shed Yes, please specifyYes, please specify No Does the property have the following? Pool Trampoline Type of Fire/Smoke Alarm * NoneLocalCentral Type of Burglar Alarm * NoneLocalCentral Mortgagee & Loan Information, if applicable Estimated Tenants? * Will tenants be allowed pets? * Yes No Projected Length of Lease * 12 Months 6 Months 1 Month Other, please specifyOther, please specify Estimated Monthly Rent $5000$0$10000 Purchase Price $ Comments If you are human, leave this field blank. Submit
