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2. OWNER INFORMATION
4. Owner Name*
5. Owner Business Name
7. Owner Mailing Address*
8. City*
10. State*
11. Zip Code*
13. Business Phone Number*
14. Evening Phone Number
16. Owner Email Address*
20. PROPERTY MANAGER OR AGENT INFORMATION (if different from property owner)
22. Property Manager/Agent Name (if different from owner)
23. Property Manager/Agent Business Name
25. Property Manager/Agent Mailing Address
26. City
28. State
29. Zip Code
31. Business Phone Number
32. Evening Phone Number
34. Property Manager/Agent email address
38. RENTAL PROPERTY INFORMATION
40. Rental Property Address*
41. Property ID Number***
42. Year Built*
44. Type of Rental*

    Check box that applies

    1. Single Unit Rental

    1. Multi-Unit Rental (2+ units)
46. Number of Units (total)*
47. Number of Units
48. with _____ bedroom(s)
50. Number of Units
51. with ____ bedroom(s)
52. Number of units
53. with ____ bedroom(s)
55. Example:

    Number of units (total):  30      Number of units  20 with  2 bedroom(s);   Number of units 10 with 1 bedroom(s), etc.

59. 1. Describe how occupant inquiries or complaints are processed.*
63. 2. Provide a blank copy of your lease including the following documents:
    1. The Crime Free/Drug Free Addendum
    2. The lead Free informational material for Pre1978 properties that has been provided to your tenants
65. Upload Copy of the Lease*
66. Upload Crime Free/Drug Free Info*
67. Upload Lead Free Info*
69. 3. Background Checks*

    Include explanation/instructions/website of how background checks are completed.

71. 4. Provide documentation showing that owner or manager/agent has completed a minimum of 8 hours of Crime Free Housing Educational Workshop or similar education.

    Documentation includes a certificate of completion or registration to the program.

    Consult the MN Crime Prevention Association for available seminars, or check with cities near you to schedule your certified seminar.

73. Upload Crime Free Education Documentation*
75. 5. Delinquent Utilities

    Provide certification that owner provided utilities are not delinquent. This can be in the form of a recent utility bill or confirmation from the utility/finance department

77. Upload Utility Info
79. 6. Rental Licensing Ordinance

    Acknowledgement that the owner/manager/agent has received a copy of the Rental Licensing Ordinance.

81. Check box below*

    1. I acknowledge that I have received the Rental Licensing Ordinance
83. Comment(s)/Questions:
87. APPLICANT AFFIDAVIT

    I hereby attest to the truth and accuracy of the information contained in this application.

89. Electronic Signature Agreement

    By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.

    1. I agree.
91. Electronic Signature
93. **To Find the Property ID Number:

    On the Anoka County website, enter your address in the search bar. 

    The number looks like this:  12-34-56-78-0000

Leave This Blank:


95. 1. Receive an email copy of this form.
96. Email address

    This field is not part of the form submission.

97. Submit Submit and Print

* indicates a required field