List Rental Property - Rate Submission Form :
    For Year 2015
www.iLoveSeaisle.com
NJ Realty, Inc. a Long & Foster Company

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Today's Date:

Owner Name:

Home Mailing Street Address:

Home City:

Home State:

Home Zip Code:

Home Phone Number:

Work Phone Number:

Cell Phone Number:

Fax Phone Number:

E-Mail Address:

2nd E-Mail Address:

Social Security # / Federal ID #:

Make Checks Payable To:

Rental Property Address:

Unit/Floor (If a Single, type in Single):

# of Bedrooms:

# of Bathrooms:

Unit Phone Number:

Maximum Number of People:

Security Deposit Protection Plan

Owner Has Pet On Premises (YES or NO):

Comcast Account #:

A/C Repair & Phone #:

Appliance Repair & Phone #:

Electrician & Phone #:

Plumber & Phone #:

Cleaning & Phone #:

Authorized to order repair work up to $300.00 - Type in below YES or NO:

Would You Consider Selling Your House (YES or NO):

Rates for 2015  (Please indicate the rent amount or rate even for weeks or periods that are rented already with a description of "Owner", "Owner Rental" or the "real estate office name", and date the rental was taken off the market.  If there is a cancellation or change we will have the rate.  For example:  3500 Owner Rental 8-25-14)