Change Form LPSS

Unit Number *

Additional units

If you have more than one unit, please separate unit numbers with a comma ","

"Occupant" Name *

First Name (Include middle initial if you'd like) Last Name

** Please only provide information below that you would like to change on your contract.

Gate Code

Please choose four numbers that will replace your current gate code.

Occupant's mailing address and phone numbers:

Address

Street Address

Street Address Line 2

City State Abbreviation (i.e. CA for California)

Zip Code

Cell phone

Please enter a valid phone number.

Home Phone

Please enter a valid phone number.

Email

example@example.com

Last Four #'s - Social Security number

Please only provide last four numbers

Drivers License No or Other Picture I.D. No (Please enter State abbreviation first)

Ex. CA C3601959 (for California Driver's License)

Occupant's Alternate Mailing Address/Information:

Note: As an Occupant, you are not required to have an alternate mailing address. It is to your sole advantage to have one. Remember, all notices under the terms of your LPSS Rental Agreement, will be sent to both your mailing address and to your alternate mailing address, if you have provided one. The alternate mailing address provides another way to receive your notices, should you not receive the notice sent to your primary mailing.

Name

First Name Last Name

Address

Street Address

Street Address Line 2

City State Abbreviation (i.e. CA for California)

Zip Code

Cell phone

Please enter a valid phone number.

Home Phone

Please enter a valid phone number.

Email

example@example.com

If you would NOT like to provide an alternate contact, please sign here:

Clear

GATE ACCESS: Up to three persons who are approved by you and Lighthouse Point may have your gate access code. If you give you access code to any unauthorized party, LPSS shall cancel your access code. Please list below the individuals you approve to have your access code.

Name

First Name Last Name

Add Remove

Phone Number

Please enter a valid phone number.

Name

First Name Last Name

Add Remove

Phone Number

Please enter a valid phone number.

Name

First Name Last Name

Add Remove

Phone Number

Please enter a valid phone number.

Photo of Driver's License (Front Only)

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Date *

Date

Occupant's Signature *

Clear

{occupantName}, please do your best to make your signature as accurate as possible :)

1221 Palmetto Ave, Pacifica, CA 94044 Tel 650 355 5005 - Fax 650 355 5028

LIGHTHOUSE POINT SELF STORAGE (LPSS)