Initial Registration Renewal
INDIVIDUAL OWNER INFORMATION
Address of Rental Dwelling Unit: Total # of Units:
Owner’s Name:
Address:
E-Mail Address:
Phone: 24/7 Emergency Contact # Work/Cell:
PARTNERSHIP INFORMATION
Partnership/Company Name:
Please list the name, business address and phone number of each partner:
CORPORATION
Corporation Name:
Foreign Corporation? (check)
YES NO Place of Incorporation:
Incorporated Uunder Texas State Laws? (circle) YES NO
Mailing Address:
Business Location:
Local Agent in Charge: Phone Number:
Email Address:
List the name of all officers, directors & trustees
PROPERTY MANAGEMENT COMPANY
Company Name & Address:
Phone Number: Email:
Agents Name: 24/7 Emergency Contact:
Owner/Agent Signature:
Date:
Rental Permit Fee Rate Table
Single-Family Dwelling Units: $50.00/ Per Unit Annually
Duplexes: $50.00/ Per Unit Annually
Multi-Family (3+Units): $25.00 Per Unit Annually
Rental Permit Fee Rate Table (Continued)
Initial Inspection NO CHARGE
Subsequent Re-Inspection(s) NO CHARGE
City of Anna
Community Services
Office: 214-504-5587
Fax: 972-924-2620
Email: kmartin@annatexas.gov
Res
idential Rental
Registration
Application
Office Use Only
DATE PAID: ______/______/________
AMOUNT RECEIVED: $ ______________
METHOD OF PAYMENT: [ ] CHECK [ ] MO [ ] CC [ ] CASH
Mail Payments To:
Water Utilities Dept.
P. O. Box 776
Anna, TX 75409
In-Person Payments:
101 S Powell Pkwy
Anna, TX 75409
972-924-2432
Amount Submitted
(
See Rate Table Below
):
$ ________________
Change in Tenancy
Mobile Home Parks: $250.00 fee plus $10.00 per lot
Single Family
Multifamily
Mobile Home Park
Check all that apply:
Instructions:
Please list all applicable residential rental dwelling units below
Use additional copies of this form if listing more than thirteen (13) properties. Attach the
completed form(s) to the Registration Application. (PLEASE PRINT)
Unit/Apt #
(if applicable)
Dwelling Type:
Single, Multi-Family, Duplex
(Please indicate below)
1
2
3
4
5
6
7
8
9
10
11
12
13
***IMPORTANT*** Please Specify Where to Direct All Correspondence
Name: _______________________________________________________________________________
Address: _____________________________________________________________________________
Telephone: __________________________ Email: ___________________________________________
Rental Registration Property Information Form