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Land Bank Property Purchase Application
First name
*
Last name
*
Middle Initial
Application Date
Email
*
Phone
*
Mailing Address
*
Are you applying as:
*
Adjacent Owner Occupant
Non-Profit Organization
Government Agency
Developer
Other
If Other, please explain:
Please list the Parcel ID(s) that you currently own:
Do you or have you had any active or past foreclosures?
*
Yes
No
Are you current on ALL of your property taxes?
*
Yes
No
Are you directly adjacent to the property you are inquiring about?
*
Yes
No
Do you currently reside on your property? If no, please explain below.
*
Yes
No
If no, please explain:
Please list the property parcel ID number(s) and/or property address that you are interested in purchasing:
*
Please select the property type:
Vacant Land
Residential
Commercial
Other
If Other, please explain:
Who are the properties currently owned by?
*
Are the properties you listed delinquent on their taxes?
Yes
No
Unknown
What is your intended use of the property you are inquiring about?
*
Signature:
*
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