OWNER/OCCUPANT INFORMATION

Owner 1 Name:________________________________________________Phone:__________________
Owner 2 Name:________________________________________________Phone:__________________
Unit Address:______________________________________________________Unit #:___________
Owner Mailing Address:_______________________________________________________________
City:__________________________________State:________________Zip Code:_______________
Tenant Name: (if applicable)_________________________________Phone:__________________
Tenant Lease Term:___________________________________________Move In Date:___________
Pet Description:_____________________________________________________________________
Auto:Make______________Model____________Year_______Color______License #______________
Auto:Make______________Model____________Year_______Color______License #______________
Emergency Contact Person:____________________________________Phone:__________________
Name of Mortgage Holder:_____________________________________________________________
Address of Mortgage Holder:__________________________________________________________
Homeowner Insurance Information/Company:_____________________________________________
Agent:___________________________Phone #:________________Policy Type:________________
 

UNIT INFORMATION

# of Rooms:______# of Bedrooms:____# of Bathrooms:_______# of Smoke Detectors:_______
Unit Style:______________Year Built:___________________Square Footage:_______________
Purchase Date:_________Purchase Price:______________Fire Alarm System:Yes/No_________
Integral Garage: Yes/No____________# of Spaces:___________Fireplace: Yes/No__________
This is a request for information only and is not a requirement. The information on this form is necessary to establish individual unit owner files. All responses will remain confidential. Please mail to:

ACRI COMMERCIAL REALTY
290 Perry Highway
Pittsburgh, PA 15229