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3. Owner Name*
4. EIN or SS #*
6. Name on Title as registered with Baldwin County*
8. Mailing Address*
10. RV Park Name*
11. Unit Number*
12. Street Address*
14. Business Phone Number
15. Cell Number*
17. Email Address*
19. List Contact persons, Owner(s), Partners, and Officers
21. Name*
22. Title*
24. Phone Number*
25. Driver License State & Number*
26. Social Security or EIN#*
28. Name
29. Title
31. Phone Number
32. Driver License State & Number
33. Social Security or EIN#
35. Rental Type*

    1. Short term rental 531115
    2. Long term -180 consecutive days 531118
36. Rented by*

    1. Owner
    2. Real Estate Company
    3. VRBO #
    4. Other #
38. Date unit was first rented
39. Management Company
40. Management Co Phone Number
42. 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.
44. Electronic Signature
45. Date
Leave This Blank:


48. 1. Receive an email copy of this form.
49. Email address

    This field is not part of the form submission.

50. Submit

* indicates a required field