2. NOTICE TO LANDLORDS
   Your unit will remain on the list for sixty (60) days and then it will be automatically removed. If you would like to re-list this unit at that time, please fill out another form.
4. Landlord's First Name*
5. Landlord's Last Name*
7. Landlord's Mailing Address*
8. Suite or Apartment Number
10. City*
11. State*
12. Zip Code*
14. Landlord's Primary Phone*
15. Landlord's Secondary Phone
17. Primary Phone Type*

    1. Home
    2. Work
    3. Mobile
18. Secondary Phone Type

    1. Home
    2. Work
    3. Mobile
20. Landlord's Email Address*
21. Landlord's Fax Number
23. Available Unit Street Address*
24. Suite or Apartment Number
26. City*
27. State*
28. Zip Code*
30. Date Unit Listed for Rent*
    Date Unit Listed for Rent
31. Date Available for Move-In*
    Date Available for Move-In
32. Number of Bedrooms*
33. Type of Unit*

    1. Single Family House
    2. 2 or More Units
    3. Apartment
35. Monthly Rent*
36. Security Deposit*
    Security Deposit cannot exceed one month's rent.
38. Landlord Furnished Utilities and Appliances*

    Please check the boxes next to the utilities and appliances the landlord will provide the tenant at no additional charge.

    1. Gas Range
    2. Electric Range
    3. Refrigerator
    4. Dishwasher
    5. Washing Machine

    1. Gas Dryer
    2. Eclectic Dryer
    3. Gas Utility
    4. Electric Utility

    1. Water/Sewer Utility
    2. Television
    3. Internet
    4. No Utilities or Appliances Furnished
40. Please list any additional features or amenities:
    (fenced yard, off-street parking, garage, patio, etc.)
Leave This Blank:


42. 1. Receive an email copy of this form.
43. Email address

    This field is not part of the form submission.

44. Submit Submit and Print

* indicates a required field