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City of West Chicago
Application
Rental Dwelling License
(Please type or print clearly)
COMPLEX NAME: __________________________________________________________________________
BUILDING ADDRESS: _______________________________________________________________________
CITY: ___________________________________ STATE: _____________
ZIP: ____________________
1. LEGAL OWNER(S) INFORMATION
NAME:____________________________________ BIRTH DATE: _______________________________
ADDRESS: _____________________________________________________________________________
CITY:________________________________ STATE: ____________
ZIP:______________________
TELEPHONE NUMBERS - WORK: ____________________
HOME: ___________________________
NAME:____________________________________ BIRTH DATE: _______________________________
ADDRESS: _____________________________________________________________________________
CITY:________________________________ STATE: ____________
ZIP:______________________
TELEPHONE NUMBERS - WORK: ____________________
HOME: ___________________________
If the owner is a land trust, please attach to this application a certified copy of a trust disclosure,
including the name and address of each person(s) holding a beneficial interest and/or power of
direction therein.
2. MANAGING AGENT INFORMATION
In the event that the owner of the multiple family dwelling resides outside the corporate limits of the
city, the owner shall appoint a managing agent that:
1. Has an office at the multiple family dwelling with regular business hours;
2. Lives at the multiple family dwelling and has regular business hours thereat; or,
3. Has an office within 30 miles of the corporate limits of the city with regular business hours.
A managing agent shall be authorized to receive notices and process on behalf of the owner.
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NAME:____________________________________ BIRTH DATE: _______________________________
ADDRESS: