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2. Please fill out this information for the individual who is the Primary Contact for licensed rental property in Dubuque.
   This is the person who will receive correspondence regarding license renewals, inspections, informational updates, etc. from the Housing & Community Development Department regarding rental properties.
4. **If you are assigning or changing the Designated Agent for your property, please scroll down to the bottom of this form, click the link to the "Designated Local Agent Form" and submit that form.**
6. My contact information needs to be updated for the following Housing & Community Development programs:

   Please select all that apply.

   1. Rental Licensing & Inspections
   2. Vacant Building Licensing
   3. Assisted Housing (Section 8, HCV)

   1. Rehabilitation Programs
   2. Lead & Healthy Homes
   3. Bee Branch Healthy Homes
8. First Name*
9. Last Name*
11. Business Name, if applicable
12. List any other Businesses (LLCs, privately-owned properties, etc) for which you are the primary contact:
14. Please list the address(es) of at least one rental property that you own/manage in Dubuque.*
18. Please enter your contact information.
20. Address 1*
21. Address 2
23. City*
24. State*
25. Zip*
27. E-mail Address
28. Phone Number (Primary)*
29. Phone Number (Secondary)
31. **If you live more than 50 miles outside of Dubuque's city limits, a designated local agent is required to be on file for any immediate property maintenance issues. Please complete the form linked to the right.**
    When you click the link, it will open in a new window/tab so the information you've entered in this form will not be lost. Simply return to this window/tab to complete and submit this form.
32. Click below to open form:
    Designated Local Agent Form
34. Comments or other special information:
36. Thank you. If you have any questions, please contact our department at (563)589-4231 or housing@cityofdubuque.org.
Leave This Blank:


38. 1. Receive an email copy of this form.
39. Email address

    This field is not part of the form submission.

40. Submit

* indicates a required field