Local ID
Business Name and Address
Business Name
Parcel Data
Property Address
Location Address 2
Location City, St Zip
Block
Lot
Qual
Business Phone
Fax
Mobile
Business Email
Type of Ownership
Private/Individual
Partnership
Condominium
Government Agency
LLC Corporation
Municipal Tax Account Number
Business Information
LHU Codes
Total Building (sq.ft.)
Knox Box
Yes
No
Key In Knox Box
Yes
No
Remarks
Owner Information
Property Owner
Property Owner Name
Property Owner Address
Property Owner Address 2
Property Owner City State Zip
Property Owner Phone
Mobile
Property Owner Email
Building Owner
Building Owner Name
Building Owner Address
Building Owner Address 2
Building Owner City State Zip
Building Owner Fed ID
Building Owner Phone
Building Owner Fax
Mobile
Building Owner Email
Business Owner
Business Owner Name
Business Owner Address
Business Owner Address 2
Business Owner City State Zip
Business Owner Fed ID
Business Owner Phone
Business Owner Fax
Mobile
Business Owner Email
Mail To Information
Mail To Name
Mail To Attn
Mail To Address
Mail To Address 2
Mail To City State Zip
Mail Phone
Fax
Mobile
Mail To Email
Manager / Agent Information
Manager / Agent Name
Manager / Agent Address
Manager / Agent City State Zip
Manager / Agent Phone
Manager email
Emergency Contacts
Emergency Contact #1
EC1 Name
EC1 Day Phone
EC1 Day Ext
EC1 Night Phone
EC1 Night Ext
Emergency Contact #2
EC2 Name
EC2 Day Phone
EC2 Day Ext
EC2 Night Phone
EC2 Night Ext
Emergency Contact #3
EC3 Name
EC3 Day Phone
EC3 Day Ext
EC3 Night Ext
EC3 Night Phone