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2. Margaret S. Torrence
   Commissioner of Revenue
   Franklin County, Virginia
   1255 Franklin St., Suite 102
   Rocky Mount, VA 24151
   Phone: (540) 483-3083
   Fax: (540) 483-3089
4. Reason for Submitting this Form?*

   1. Address Change
   2. Name Change
   3. New Account
6. APPLICANT
8. Owner Name(s)
9. Contact Person
11. Property Address*
    Enter the street address of the rental property
13. City*
14. State*
15. Zip Code*
17. Is the mailing address the same as the property address?*

    1. Yes
    2. No
19. Mailing Address*
    Enter your mailing address (Number and Street Name or PO Box)
21. City*
22. State*
23. Zip Code*
25. Primary Phone*
26. Secondary Phone
28. Email Address
29. Rental Listing Website Address
31. Start Date in Franklin County*
    Start Date in Franklin County
33. Property Manager*

    1. Rental Agency
    2. Self
34. If Rental Agency, Please List Name:*
38. CONTACT PLANNING & COMMUNITY DEVELOPMENT
    Please contact the Franklin County Planning & Community Development Office at 540-483-3027 to obtain approval and inquire on zoning regulations that may apply to your short-term rental property.
40. Electronic Signature Agreement*

    By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.

    1. I agree.
42. Electronic Signature
43. Date
    Date
45. IMPORTANT MESSAGE: The Commissioner of Revenue office will contact you via phone or email to obtain additional information needed to process this request.
Leave This Blank:


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

    This field is not part of the form submission.

49. Submit

* indicates a required field