1. Rental Property Owner's name:
2. Rental Property Address:
3. Owner's mailing address: (if different from above)
4. Owner's telephone number:
Is owner a(n):
Owner(s) of Business: If an individual, give name, date of birth, residence address, number, and
social security number; if a partnership, give same as above for each partner; give same for
President, Vice-President, Secretary, and Treasurer.
*Note that this form must be completed and returned to the City Clerk's Office for review by
appropriate City Staff. Also, a separate application must be completed for each piece of rental
property owned within the City of Bellevue.
List a duly authorized representative of the business who is