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Landlord Registration Form

  1. Landlord Registration Form

  2. Owner's Information (if company or trust, list name of owner)

  3. Property Address for the Rental Permit

  4. If owner resides outside of Fitchburg, give the contact information for the Property Manager or Agent

  5. List unit number and who supplies utilities or fuel

  6. Have you received any lead compliance letters?*

  7. If yes, provide a copy of all letters received to the Health Department

  8. Leave This Blank:

  9. This field is not part of the form submission.