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  • 1419 Eastholme

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    Silverio Barroqueiro
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    This document is a 2017 rental property registration application for the property located at 1419 EASTHOLME AVE in Bloomington, IL. It provides the owner and authorized agent's contact information, acknowledges the registration fee of $71.50, and requires the signatures of the legal owners to certify the accuracy of the information provided and agree to notify the city of any changes to the registration.

    Original Description:

    Contract on Bloomington, IL House.

    Original Title

    1419 eastholme

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    © © All Rights Reserved

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    This document is a 2017 rental property registration application for the property located at 1419 EASTHOLME AVE in Bloomington, IL. It provides the owner and authorized agent's contact information, acknowledges the registration fee of $71.50, and requires the signatures of the legal owners to certify the accuracy of the information provided and agree to notify the city of any changes to the registration.

    Copyright:

    © All Rights Reserved
    Flag for inappropriate content
    12 views1 page

    1419 Eastholme

    Uploaded by

    Silverio Barroqueiro
    This document is a 2017 rental property registration application for the property located at 1419 EASTHOLME AVE in Bloomington, IL. It provides the owner and authorized agent's contact information, acknowledges the registration fee of $71.50, and requires the signatures of the legal owners to certify the accuracy of the information provided and agree to notify the city of any changes to the registration.

    Copyright:

    © All Rights Reserved
    Flag for inappropriate content
    of 1

    2017RentalPropertyRegistrationApplication

    InaccordancewithCityCodeChapter45

    RentalAddress: 1419EASTHOLMEAVE ParcelNumber: 1434308011


    BusinessID/License: 8545/1060

    ‰ CheckhereifthispropertyhasbeenSOLD.Pleasereturnthisdocumentwithnewowner’snameanddateofsale.
    NewOwner: DateofSale:

    ‰ CheckhereifthispropertyisaSingleFamilyResidence,vacantandNOTintendedtoberented.

    RegistrationType: RENTREG:SFRW/INSPECTION NumberofUnits 1

    CurrentInformation UpdatedInformation
    StreetaddressrequiredPOBoxisinsufficient.
    LegalOwner: BARROQUEIRO,SIVERIOA&NOEMIAR Name:
    CustID: 15691 110WHEELERPATH Address:
    GUILFORD,CT06437 Hold:
    City:
    State: Zip:
    Phone:

    AreLegalOwnerandAuthorizedAgentidentical ‰ Yes ‰ No
    Informationbelowwillbechangedto Pleasereviewthefollowinginformation
    matchinformationabove. andupdateifnecessary.

    CurrentInformation UpdatedInformation
    StreetaddressrequiredPOBoxisinsufficient.
    AuthorizedAgent BARROQUEIRO,SIVERIOA&NOEMIAR Name:
    CustID: 15691 110WHEELERPATH Address:
    GUILFORD,CT06437 Hold:
    City:
    State: Zip:
    Phone:

    RegistrationFee: $71.50 BillNumber: 41209


    ReturnformandpaymentbyMarch17,2017 to: CityofBloomington– RentalProgram
    CommunityDevelopment
    POBOX3157
    Bloomington,IL617023157

    I/Wetheundersignedherebycertifythat:

    1. Thedatasubmiedinthisapplicaonisanaccuraterepresentaon,asofthedateoftheapplicaon,andtheregistraonstatementshallserveasprima
    facieproofofthestatementsinanyadministrativeenforcementofcourtproceedingsinstitutedbytheCityagainsttheownerorownersofthedwelling.

    2. I/WeunderstandthatitisillegaltooperatearentalunitywithintheCityofBloomingtonwithoutaCercateofRegistraon.Failuretoprovideaccurate
    informationwillresultinlegalactionsandfines.
    3. I/Weunderstandthatbydesignangasauthorizedagent,I/Weareconsenngtoserviceofanyandallnocesofcodeviolaonsconcerningthe
    registeredbuildingandallprocessbyserviceofthenoticeorprocessontheauthorizedagent.

    4. I/WeunderstandthatI/wemustleanamendedregistraonstatementwithin(10)businessdaysofanychangesintheregistraonstatement.
    5. I/WeunderstandthatI/wemustcontactCommunityDevelopmentifthepropertyissoldin2017.

    Signaturerequired–formwillbereturnedifleftunsigned. Date

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