Form CCS-FRM-274 "Multi-Tenant Registration Application and Renewal" - City of Dallas, Texas

What Is Form CCS-FRM-274?

This is a legal form that was released by the Code Compliance Department - City of Dallas, Texas - a government authority operating within Texas. The form may be used strictly within City of Dallas. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on October 1, 2015;
  • The latest edition provided by the Code Compliance Department - City of Dallas, Texas;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;

Download a printable version of Form CCS-FRM-274 by clicking the link below or browse more documents and templates provided by the Code Compliance Department - City of Dallas, Texas.

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Download Form CCS-FRM-274 "Multi-Tenant Registration Application and Renewal" - City of Dallas, Texas

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______________
Account Number:
Multi-Tenant Registration Application
Renewal
New
IMPORTANT!!! - A CERTIFICATE OF REGISTRATION WILL NOT BE ISSUED UNTIL ALL CURRENT FEES AND FINES RESULTING FROM THE OPERATION
OF THE MULTI-TENANT PROPERTY (OR PROPERTIES) ARE PAID OR SETTLED. ALL OF THE INFORMATION REQUIRED IN THE APPLICATION MUST BE
PROVIDED IN ORDER TO PROCESS THE REGISTRATION.
(FOR OFFICE USE ONLY)
______________________________
_______/______/_______
ACCOUNT NUMBER:
DATE PAID:
$_________________
: ___________________________
LICENSE FEE PAID:
INSTRUMENT NUMBER
INSTRUMENT TYPE: [ ] CK [ ] MO [ ] CC [ ] CASH
_____________________________________________________________
PAYOR:
(If different than customer/applicant, capture address, C/S/Z, phone number)
___________________________________________________________
ADDRESS:
___________________________ STATE: _____ ZIP: __________-________
_______-__________
CITY:
PHONE: (______)
This application must be completed by the person who owns, operates, or controls the property, and returned with the applicable,
nonrefundable fee of $6.00 per unit, whether occupied or unoccupied. Please update any information that is incorrect on this application in
the spaces provided below.
Applicant’s Name:
Applicant’s Phone No:
Applicant’s Address / Zip Code:
Multi-Tenant Property or Properties owned by an: ___Individual ____Corporation ____Partnership ____ Other: _______________________
(Specify)
__________________________________________________________________________________________________
Property Owner(s) of Record:
Property Owner(s) Address:
___________________________________________________________________________________________________
Property Owner(s) Business Phone: _________________________ Fax: ___________________ Email: ____________________________________
If this property is owned by a corporation, provide the following information:
1. Name of Corporation’s Registered Agent: ___________________________________Phone: ____________________ Fax: ____________________
2. Registered Agent Address: __________________________________________________________________________________________________
3. Name of Corporation’s President: _________________________________________ Phone: ____________________ Fax: ____________________
4. Corporation’s President Business Address:____________________________________________________________________________________
If property owned by a partnership or other business association, provide name, address and telephone number of a high managerial agent. “High
Managerial Agent” means partner(s) in a partnership, officer(s) of a business association, director(s) of a business association, or any agent/employee
who has the duties of such responsibility that the agent’s/employee’s conduct represents the policy of the partnership or business association.
Name(s) of High Managerial Agent(s): ___________________________________________________________________________________________
Job Title of Managerial Agent(s): _______________________________________________________________________________________________
Business Address(s) of High Managerial Agent: __________________________________________________________________________________
________________________________________________________________________
Phone: ____________________________________________
I am the person who owns, controls, or operates the Multi-Tenant property that is the subject of this application. I have read the completed application and know the same
is true and correct and hereby agree that, if a certificate of registration is issued, I will comply with all applicable provisions of Chapter 27 of the Dallas City Code, as
amended, and all applicable state laws. I accept responsibility for payment of all fees and fines that may result from the operation of the Multi-Tenant property.
Signature of Owner/Operator/Person in Control (Required)
)
Driver’s License or Identification Number – Issuing State (Required
Page 1 of 2
CCS-FRM-274
Effective Date 10/1/2015
Rev 7
______________
Account Number:
Multi-Tenant Registration Application
Renewal
New
IMPORTANT!!! - A CERTIFICATE OF REGISTRATION WILL NOT BE ISSUED UNTIL ALL CURRENT FEES AND FINES RESULTING FROM THE OPERATION
OF THE MULTI-TENANT PROPERTY (OR PROPERTIES) ARE PAID OR SETTLED. ALL OF THE INFORMATION REQUIRED IN THE APPLICATION MUST BE
PROVIDED IN ORDER TO PROCESS THE REGISTRATION.
(FOR OFFICE USE ONLY)
______________________________
_______/______/_______
ACCOUNT NUMBER:
DATE PAID:
$_________________
: ___________________________
LICENSE FEE PAID:
INSTRUMENT NUMBER
INSTRUMENT TYPE: [ ] CK [ ] MO [ ] CC [ ] CASH
_____________________________________________________________
PAYOR:
(If different than customer/applicant, capture address, C/S/Z, phone number)
___________________________________________________________
ADDRESS:
___________________________ STATE: _____ ZIP: __________-________
_______-__________
CITY:
PHONE: (______)
This application must be completed by the person who owns, operates, or controls the property, and returned with the applicable,
nonrefundable fee of $6.00 per unit, whether occupied or unoccupied. Please update any information that is incorrect on this application in
the spaces provided below.
Applicant’s Name:
Applicant’s Phone No:
Applicant’s Address / Zip Code:
Multi-Tenant Property or Properties owned by an: ___Individual ____Corporation ____Partnership ____ Other: _______________________
(Specify)
__________________________________________________________________________________________________
Property Owner(s) of Record:
Property Owner(s) Address:
___________________________________________________________________________________________________
Property Owner(s) Business Phone: _________________________ Fax: ___________________ Email: ____________________________________
If this property is owned by a corporation, provide the following information:
1. Name of Corporation’s Registered Agent: ___________________________________Phone: ____________________ Fax: ____________________
2. Registered Agent Address: __________________________________________________________________________________________________
3. Name of Corporation’s President: _________________________________________ Phone: ____________________ Fax: ____________________
4. Corporation’s President Business Address:____________________________________________________________________________________
If property owned by a partnership or other business association, provide name, address and telephone number of a high managerial agent. “High
Managerial Agent” means partner(s) in a partnership, officer(s) of a business association, director(s) of a business association, or any agent/employee
who has the duties of such responsibility that the agent’s/employee’s conduct represents the policy of the partnership or business association.
Name(s) of High Managerial Agent(s): ___________________________________________________________________________________________
Job Title of Managerial Agent(s): _______________________________________________________________________________________________
Business Address(s) of High Managerial Agent: __________________________________________________________________________________
________________________________________________________________________
Phone: ____________________________________________
I am the person who owns, controls, or operates the Multi-Tenant property that is the subject of this application. I have read the completed application and know the same
is true and correct and hereby agree that, if a certificate of registration is issued, I will comply with all applicable provisions of Chapter 27 of the Dallas City Code, as
amended, and all applicable state laws. I accept responsibility for payment of all fees and fines that may result from the operation of the Multi-Tenant property.
Signature of Owner/Operator/Person in Control (Required)
)
Driver’s License or Identification Number – Issuing State (Required
Page 1 of 2
CCS-FRM-274
Effective Date 10/1/2015
Rev 7
Account No.
Customer No.
Multi-Tenant Property Information Form
Attach to the Multi-Tenant Registration Application
Renewal
New
IMPORTANT!!! – A separate form must be completed for each Multi-Tenant Property being registered Use additional copies of this form to register more
than one Multi-Tenant Property. Attach form(s) to the Multi-Tenant Registration Application.
Name of Multi-Tenant Property:
Also known as (Aka):
Address of Multi-Tenant Property:
Property Phone No:
Property Fax No:
Property E-Mail:
No. of Buildings: _________ No. of Dwelling Units: ____________ No. of Pools: __________
No. of Spas: ______________
Total No. of Bedrooms: ______________ (A unit with no separate bedroom will be counted as one bedroom)
Current Occupancy Rate Expressed as a Percent: ________________% Certificate of Occupancy #_______________________________.
Is the owner an entity? [ ] Yes [ ] No
If yes, a copy of the documents establishing the business must be submitted with this application.
Type of Property:
[ ] Apartment [ ] Boarding Home [ ] Three-plex [ ] Four-plex [ ] Group Home [ ] Loft [ ] Town home
[ ] Condo – Individual Unit (Suite) Numbers of Rental Units must be noted here __________________________________________
Type of Boarding Home:
[ ] Handicapped Group Dwelling [ ] Lodging or Boarding House [ ] Residential Hotel [ ] Group Residential Facility
[ ] Extended Stay Hotel or Motel
Phone
:
Property Manager’s Name:
_______________________________________________
______________________
Property Manager’s Address:
Phone:
_______________________________________________
______________________
Do you currently offer recycling to your residents? [ ] Yes
[ ] No
The Multi-Tenant manager / person in charge must also provide the following information if applicable:
Name of Property Lien holder(s):
Address of Property Lien holder(s):
Phone #s’ of Property Lien Holders:
Name of Insurance Provider:
Phone
Address of Insurance Provider:
Name of Crime Watch Attendant Designee:
Phone
Address of Crime Watch Designee:
Alternate Contact Name/Address/Phone:
I am the person who owns, controls, or operates the Multi-Tenant property that is the subject of this application. I have read the completed application and know the same
is true and correct and hereby agree that, if a certificate of registration is issued, I will comply with all applicable provisions of Chapter 27 of the Dallas City Code, as
amended, and all applicable state laws. I accept responsibility for payment of all fees and fines that may result from the operation of the Multi-Tenant property.
Signature of Owner/Operator/Person in Control (Required)
Driver’s License or Identification Number – Issuing State (Required
)
Page 2 of 2
CCS-FRM-274
Effective Date 10/1/2015
Rev 7
Page of 2