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2. Contact Information for the Owner of the Rented Premises

   Please provide the contact information for the owner or the legal respresntative(s) to the premises.

4. Property Owner No. 1 or Legal Representative

   Please complete the below fields

6. Owner No. 1 First and Last Name*
7. Owner No. 1 Telephone No.*
8. Owner No. 1 Email Address*
10. Owner No. 1 Mailing Address, (street, city, zip code)*
11. Owner No. 1 Signature*
15. Property Owner No. 2 or Legal Representative

    Please complete the fields below if there is more than one property owner.

17. Owner No. 2 First and Last Name
18. Owner No. 2 Telephone No.
19. Owner No. 2 Email Address
21. Owner No. 2 Mailing Address (street, city, zip code)
22. Owner No. 2 Signature
24. Property Owner Consent
26. Consent of Property Owner*

    1. Yes, I attest

    By checking this box I attest that I have received written consent from the property owner to rent the above-referenced premise.

27. Written Consent of Property Owner*

    Please upload/attache the written consent of the property owner here.

31. Notice - Agent Required

    If the applicant is not based in the Township, they must appoint an authorized agent who can accept legal documents and fulfill the necessary requirements for licensing on behalf of the applicant.

33. Agent First and Last Name
34. Agent Telephone No.
35. Agent Email Address
37. Agent, Mailing Address (street, city, zipcode)
41. Property Details
43. Block*
44. Lot*
45. Property Location*
47. Single or Multifamily Dwelling*
    -- Select One --Single Family DwellingMulti Family Dwelling (legal non-conforming)
48. Multifamily dwellings must provide proof from the Land Use Office that the structure is legally nonconforming
52. Items of Consent
54. Consent to no former revocation or suspension*

    1. I consent

    By checking this box, I consent that I have not received any previous revocation or suspension.

56. Consent to Comply with Zoning Regulations*

    1. I consent

    By checking this box, I consent that I am not violating the Zoning Regulations of the Township. 

58. Consent to comply with amount of guests*

    1. I consent

    By checking this box I consent that no more than two (2) Transient Guests may occupy a Residential unit bedroom at any one time.

62. Required items
64. Fire Prevention*

    1. Yes, I attest

    By checking this box I attest that I have received written approval from the Bureau of Fire Prevention in accordance with §149-7 which requires the following: Every 30 days, the registered host shall schedule a Fire Inspection with the Wall Township Bureau of Fire Prevention. Registered hosts must demonstrate that the residential unit is equipped with a fire extinguisher, carbon monoxide detector and smoke detector pursuant to Wall Township Municipal Code Chapter 113.  The fee associated with this inspection shall be $75.00. The request for inspection must be made more than five (5) days before the date required for inspection.

65. Assessments*

    1. Yes, I attest

    By checking this box I attest that I provided proof of payment of property taxes, assessments against the property and municipal water and sewer charges pursuant to N.J.S.A. §40:52-1.2.

67. Insurance*

    1. Yes, I attest

    By checking this box I attest that as the registered host, I shall maintain property liability insurance in an amount of no less than $500,000.00. or demonstrate that a transient space marketplace maintains liability coverage in an equal or higher amount. 

68. Property Liability Insurance*

    Please upload your current policy here

72. Signatures and Fees
74. Signature*

    Signature of the owner or representative

75. Date Signed*
77. Fees

    Designation as a registered host shall be for a duration of no more than a (1) year with an expiration of March 31^st. The fee for such a designation shall be $200.00 per year.

78. Acknowledgement*

    1. I acknowledge

    By checking this box I acknowledge that payment of $200.00 is due to the Office of the Municipal Clerk no later than March 31.

Leave This Blank:


80. 1. Receive an email copy of this form.
81. Email address

    This field is not part of the form submission.

82. Submit Submit and Print

* indicates a required field