Worthington Hills, KY - Vacant House Registration Form

Property Address

Street Address

Street Address Line 2

CityState

Zip Code
Is the property a vacant Rental Home?
Is the home registered as a Rental Property with the City of Worthington Hills?
Is the home registered as a Rental Property with Louisville Metro Government?
Is the Property in Foreclosure?
Name of Property Owner or Financial Institution
Property Owner's or Financial Institution's Address

Street Address

Street Address Line 2

CityState

Zip Code
Contact's Email
example@example.com
Contact's Phone Number
Format: (000) 000-0000.
Contact's Signature
Date

MonthDayYear
Enter the message as it's shown
Should be Empty: