Application for Service Form (2019) – Landlord Services, LLC

Business Owner Name*

First Middle Last

Business Billing Name*

Business Billing Address

(NOTE: If different than Office Location)

Street Address Address Line 2 City State ZIP Code

Any LLC Names or DBA Names

Business Phone Number*

Alternate Phone Number

Contact Name

If different than Business Owner Name

First Last

Business Email*

Enter Email Confirm Email

Business Details

Are you a member of a State Trade Association?*

i.e. WI Apt Assc, WI Housing Alliance, Etc

State Trade Association Name

End User Type*

Number of Rental Properties*

Rental Property 1 - Address*

Street Address Address Line 2 City State ZIP Code

Rental Property 1 - Proof of Ownership*

(i.e. Tax Bill, Deed, or Commercial Insurance Page)

Rental Property 2 - Address*

Street Address Address Line 2 City State ZIP Code

Rental Property 2 - Proof of Ownership*

(i.e. Tax Bill, Deed, or Commercial Insurance Page)

Rental Property 3 - Address

Street Address Address Line 2 City State ZIP Code

Rental Property 3 - Proof of Ownership*

(i.e. Tax Bill, Deed, or Commercial Insurance Page)

Rental Property 4 - Address*

Street Address Address Line 2 City State ZIP Code

Rental Property 4 - Proof of Ownership

(i.e. Tax Bill, Deed, or Commercial Insurance Page)

Rental Property 5 - Address*

Street Address Address Line 2 City State ZIP Code

Rental Property 5 - Proof of Ownership*

(i.e. Tax Bill, Deed, or Commercial Insurance Page)

Where did you hear about our service?

Copy of Business Owner Drivers License or Business License*

Signature

I understand that I am not allowed to pull my own credit report using this service. Doing so will be grounds for termination and would be a violation of the Fair Credit Reporting Act and this contract.

End User Signature*

End User Printed Name*

First Last

End User Billing Name*

Date

Name

This field is for validation purposes and should be left unchanged.