Property Registration Form

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Instructions:

Please use a separate registration form for each building or complex

  • Make checks payable to UnionTownship
  • Return the completed registration along with the registration/inspection fee by mail or in person to:

UnionTownship

Code Department

1910 Municipal Drive

New Castle, PA 16101

  • An inspection date will be scheduled after registration and payment have been received
  • If you need additional assistance please contact us at 724-658-5497 or by email at or visit our website at

Type of Registration(check the applicable box below)

□Initial Registration
□Registration Renewal
□Update Property or Ownership Information

Property Information

Property Address / City / State / Zip
Parcel Number
Type of Structure (check the applicable box below)
□ Single Family / □ Duplex / □ Triplex / □ Apartment Building
Number of Units: ______/ □ Vacant Dwelling Structure

Fee Schedule(Make checks payable to Union Township)

Type of Fee / Price / Quantity / Total
Annual registration/inspection fee / $75.00
Fee for each additional unit in same structure / $25.00
Late registration fee (after February 15) / $25.00
Total Payment

Owner Information(refers to the owneror owners who hold legal title to the property)

Name
Address
City / State / Zip
Primary Phone / Secondary Phone
Email / Preferred Method of Contact

Management Company(if a management company such as a trust, partnership or corporation is responsible for the property)

Name
Address
City / State / Zip
Primary Phone / Secondary Phone
Email / Preferred Method of Contact

Responsible Agent Information(refers to a person authorized by the owner to act in his behalf)

Name
Address
City / State / Zip
Primary Phone / Secondary Phone
Email / Preferred Method of Contact

Tenant Information(List the names of ALL occupants that are eighteen (18) years old and over. Write VACANT in the name space below if the unit is unoccupied)

Name / Primary Phone / Secondary Phone
Name / Primary Phone / Secondary Phone
Name / Primary Phone / Secondary Phone
Name / Primary Phone / Secondary Phone
Name / Primary Phone / Secondary Phone

Oath/Certification/PaymentEvery registration shall be made under oath and shall contain the information required to identify the owner of the dwelling(s) to be registered, contact information including a street address and telephone numbers, and identification and contact information for any manager or other alternate contact person for the dwelling(s). By signing and mailing this Registration Form you as the owner are certifying that the information provided in this registry is true and accurate to your best knowledge. This registration does not deem the property as code compliant or habitable.

Signature______Date______

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Total Amount Due:______

Check:______

Cash:______

Money Order:______