Neighborhood Team Assistance Application

Neighborhood Team Assistance Application
Property Owner Information
Owner Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*
Please enter a valid phone number.
Email
example@example.com
Are you completing this application on behalf of the owner?*

YesNo
Your Name*

First NameLast Name
Phone Number*
Please enter a valid phone number.
Email*
example@example.com
Do you have power of attorney for the owner?*

YesNo
Number of People Living in the Home*
Annual Household Income*
Do you own any additional property?*

YesNo
Do you collect any rental income?*

YesNo
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Please note that the N-Team is unable to do interior renovations/repairs, except for plumbing and accessibility accommodations.
Assistance requested with the following (check all that apply):*

Accessibility RampCarpentryExterior PaintFence RepairJunkOvergrowth RemovalPlumbingRoof Patch/TarpTrash and Debris RemovalOther (Please Specify)
Codes Compliance Assistance Violation Notice Received*

YesNo
"I,Full Name*, swear or affirm, the information provided herein is true and accurate to the best of my knowledge and any false information provided may be grounds for denial of assistance."
Signature*

Clear
Date*

MonthDayYear
La ciudad de St. Petersburg se compromete a garantizar que el acceso al programa vital esté disponible para todos los ciudadanos y visitantes. Si necesita traducción de idiomas para acceder a esos programas, comuníquese con el Coordinador de Diversidad y ADA de la Ciudad al 727-893-7345 o lendel.bright@stpete.org
More information on Codes Compliance Assistance at www.stpete.org/codes
Should be Empty:

Neighborhood Team Assistance Application

Property Owner Information