Horizon Land Management, LLC Birchwood MHC, LLC Tenant Registration Lot Address: ______________________________________________
Date: ____________
Mobile Home Information: Make: _________________ Model: ________________ Year: _______ Color: _____________ VIN #: ____________________ Width: _____ Length: _____ State of Registration: _________ Registered Owner (if not applicant): ________________________________________________ Is there a debt or lien on this home? _________________ Amount of debt or lien: __________ If so, who is the lien holder? _______________________ Phone No: ____________________ Insurance Provider: ______________________________ Contact Name: _________________ Policy Number: _________________________________ Contact Phone No. ______________ Tenant Information: Name: _____________________________ DOB: ______________________________ SSN: _______________________________
Make/Model/Year of Car:________________ ____________________________________ State of Registration: ___________________ License Plate No: ______________________
Make/Model/Year of Car: ______________ ___________________________________ State of Registration: __________________ License Plate No: _____________________
Copy of valid driver’s license is required.
Copy of valid driver’s license is required.
Other Vehicle: ________________________ State of Registration: ___________________ License Plate No: ______________________
Other Vehicle: _______________________ State of Registration: __________________ License Plate No: _____________________
Employer: ____________________________ Employer Address: _____________________ _____________________________________ Work Phone No: _______________________
Employer: ___________________________ Employer Address: ____________________ ____________________________________ Work Phone No: _____________________
(Continue to Back Side) Have you ever filed bankruptcy? Yes / No When? ______________________________
Have you ever filed bankruptcy? Yes / No When? _____________________________
Have you ever been evicted? Yes / No When? _________ Explain: ____________ _____________________________________
Have you ever been evicted? Yes / No When? __________ Explain: __________ ___________________________________
Have you ever been convicted? Yes / No When? __________ Explain: ____________ _____________________________________
Have you ever been convicted> Yes / No When? __________ Explain: __________ ____________________________________
Have you ever been accused or convicted of a sex offence? Yes / No When? __________ Explain: ____________ _____________________________________
Have you ever been accused or convicted of a sex offence? Yes / No When? __________ Explain: __________ ___________________________________
Additional Occupant Information: A. _______________________ Relationship ____________________ Birth Date ___________ B. _______________________ Relationship ____________________ Birth Date ___________ C. _______________________ Relationship ____________________ Birth Date ___________ D. _______________________ Relationship ____________________ Birth Date ___________ Pet Information: If you have any a cat(s) and/or dog, please fill out the attached pet registration form. I DECLARE THAT THE FOREGOING INFORMATION TO BE TRUE & CORRECT. In order to best serve you and your community, it is very important to us, as Park Owners, to have complete and accurate information on all of our tenants. Please complete this tenant and pet registration (if applicable) and return to the onsite Park Manager in 30 days. Failure to register all tenants and pets with the Park is a violation of Park procedures. Tenant: ___________________________ Date: _______________________________
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Birchwood Shopping Event Sunday, December 15 Have some birthday, special occasion, or holiday shopping to do? 'Tis. the season! Or maybe you deserve a ...