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Foreclosure Registration Form

2. Date of Filing*
   Date of Filing

3. Case Number*

5. Property Address*

6. PPN Number*

10. Current Property Owner

12. Name*

14. Address*

16. City*

17. State*

18. Zip Code*

20. Phone*

24. Person / Entity Filing Foreclosure

26. Legal Name*

28. Address*

30. City*

31. State*

32. Zip Code*

34. Phone*

35. Email*

39. Foreclosure Legal Counsel

41. Name*

43. Address*

45. City*

46. State*

47. Zip Code*

49. Phone*

50. Email*

54. Mortgage Property Maintenance Company

56. Name*

58. Address*

60. City*

61. State*

62. Zip Code*

64. Phone*

65. Email*

67. Signature*

    1. By checking this box, I authorize my signature.

68. Date*
    Date

70. Fees
    Registration fee $150. After 30 days of foreclosure filing an additional $150 late fee applies for a total fee of $300. Please make checks payable to City of Shaker Heights.

    Registration fee $150. After 30 days of foreclosure filing an additional $150 late fee applies for a total fee of $300. Please make checks payable to City of Shaker Heights.

72. Submission Instructions
    Please print this form using the button below and mail to:<br><br> Housing Department<br> City of Shaker Heights<br> 3450 Lee Rd.<br> Shaker Heights, OH 44120<br><br> This form must be submitted within 30 days of the filing of the foreclosure. (Section 107.08). If you have any questions please call Joanne Dutches at 216-491-1469 or Reginald Evans at 216-491-1478.

    Please print this form using the button below and mail to:
    
    Housing Department
    City of Shaker Heights
    3450 Lee Rd.
    Shaker Heights, OH 44120
    
    This form must be submitted within 30 days of the filing of the foreclosure. (Section 107.08). If you have any questions please call Joanne Dutches at 216-491-1469 or Reginald Evans at 216-491-1478.

76. For Office Use Only

78. Date Received

79. Receipt Number

80. Received By

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81. Print Only

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