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4. Please complete all required fields and attach all necessary documentation when submitting this form.  Incomplete submissions will not be accepted.

6. Today's Date*
   Today's Date
8. Property Owner*

   Are you the property owner of this residence?

   1. Yes
   2. No
10. Applicant Information
12. Name*
14. Service Address*
16. City*
17. State*
18. Zip Code*
20. Phone Number*
21. Email Address*
23. Different Mailing*

    Do you have a different mailing address?

    1. Yes
    2. No
25. Address
27. City
28. State
29. Zip Code
31. Additional Documents
33. Settlement Statement or Lease*

    PDF only file type accepted

35. Picture ID*

    ID must be a government issued id.  Example: Driver's License or Passport

37. I understand that a $15 application fee and required deposit will be billed to the account for all new owners.

    The customer may be held responsible for all outstanding balances on the property and may have to contact his/her title insurance to facilitate payment. If the property was foreclosed on and purchased through auction at the courthouse, it is strongly recommended that a City Lien search is requested to see if there are outstanding liens/violations on the property. 

    The City of Margate does not open water and sewer accounts for tenants. The account will always be in the property owner’s name. A courtesy copy of the bill can be mailed to the tenant if a valid lease is emailed to Water Billing

39. Electronic Signature Agreement

    By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.

    1. I agree.
41. Electronic Signature
Leave This Blank:


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

    This field is not part of the form submission.

45. Submit Submit and Print

* indicates a required field