Form Instructions

1. Click the link “Non-Resident Landowner Registration Form” to open the form (Adobe Acrobat Reader required)
2. Either print the form or fill out the information following the instructions below
3. Check the correct box to indicate if this is an “initial registration” or “Change of Non-resident owner address”
4. If the non-resident owner is and individual, go to step 5, otherwise skip to step 9
5. Enter the non-resident owner’s “Last name, First name and Middle Initial”
6. Enter the non-resident owner’s “Street address, Town/City, State and Zip Code” where they can be contacted (note: Post Office Box is not accepted)
7. Enter the non-resident owner’s main contact telephone number, alternate telephone number (i.e. cell, work) and a valid email address
8. Go to step 13
9. Enter the non-resident owner “Company Name”
10. Check the box that best describes the company (i.e. LLC, Corp., Trust, etc.)
11. Enter the “Agent Name, Street Address, Town/City, State and Zip Code” where they can be contacted (note: Post Office Box is not accepted)
12. Enter the non-resident owner’s main contact telephone number, alternate telephone number (i.e. cell, etc.) and a valid email address
13. Enter the “Street Number, Street and Unit Number (if applicable)” for the Property/Rental Address o Repeat this information for each Property/Rental Address being registered o Note: if a second page is required, be sure to enter the Non-resident Owner information as above
14. Print the completed form
15. The completed form can be mailed or delivered to:
    
    Town Clerk
    City of Waterbury
    235 Grand Street
    Waterbury CT 06702

*Note - After October 1, 2012, the Fee For Registration is $25 per property, with a maximum of $50 per Non-resident owner. The fee for change of address per property is $10, with a maximum of $20 per non-resident owner. Please enclose check or money order payable to City of Waterbury-Town Clerk.

Application Form