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2. Renewal fee $100 annually

   Additional $200 late fee assessed after March 1st.

4. Short-Term Rental Property Address:*
6. City:*
7. State:*
8. Zip Code:*
10. Prior Registration Number:*
11. Tax Map and Lot:*
13. Owner's Name:*
14. Owner's Phone Number*
16. Owner's Email Address*
18. Owner's Mailing Address*

    Please use the address we should be mailing the license to. 

20. Dwelling Type:*

    1. One Family
    2. Two Family
    3. Multi-Family
    4. Accessory Apartment
21. Type of Renewal Application:*

    1. With Changes
    2. Without Changes
23. If you had changes to the property in the last year, describe the nature of those changes.

25. The owner must identify a registered agent to representative for emergency contact purposes. The emergency contact may be the property owner. The emergency contact person must be able to respond within sixty minutes (24 hours per day) to complaints regarding the condition, safety, or operation of the short-term rental or the conduct of guests and must be able to take such remedial action on behalf of the owner, or as otherwise allowed by law, to resolve such complaints.

27. Emergency Contact Name:*
29. Emergency Contact Physical Address:*
31. City:*
32. State:*
33. Zip Code:*
35. Emergency Contact Email Address:*
36. Emergency Contact Phone Number:*

38. Liability Insurance in the amount of $1,000,000 must be maintained on your Short-Term Rental. If your property is listed on a hosting platform such as Airbnb or VRBO, simply upload a copy of the listing. If you maintain private insurance, please upload the binder showing the coverage minimum and property address.

40. Proof of Insurance:*

42. The electronic signature certifies that I am the legal owner of the subject property and that the information provided on this form is in all respects true and accurate to the best of my knowledge and belief. I agree that I have reviewed the Town of Freeport Chapter 61 Short-Term Rental Registration Ordinance and Chapter 39 the Town of Freeport Loitering, Curfew and Noise Ordinance understand the described regulations and agree to abide by them.

44. Electronic Signature:*
Leave This Blank:


46. 1. Receive an email copy of this form.
47. Email address

    This field is not part of the form submission.

48. Submit

* indicates a required field