{"content":[{"text":"Borough of Womelsdorf \n Application for Residential Transfer of Property Certificate of Occupancy","bbox":{"left":0.094118,"top":0.036397,"width":0.681962,"height":0.043302999999999994}},{"text":"INSTRUCTIONS: \n 1. Fully complete the application making sure to date and sign it. \n 2. Calculate total fees due. \n 3. Make *check or money order payable to Borough of Womelsdorf. \n 4. Send form and check or money order to: \n Borough of Womelsdorf \n 101 W High Street \n Womelsdorf, PA 19567 \n APPLICANT INFORMATION:","bbox":{"left":0.094118,"top":0.09827,"width":0.6300629999999999,"height":0.156456}},{"text":"Applicant Name: ________________________________________________________________________ \n Company Name (if applicable): __________________________________________________________ \n Applicant Address: _______________________________________________________________________ \n City: ___________________State: _____Zip: __________ Email:___________________________________ \n Phone:( )___________________Cell:( )_____________________Fax:( )_____________________ \n Check One: Owner Owner Agent Buyer Buyer Agent \n PROPERTY INFORMATION:","bbox":{"left":0.094118,"top":0.264034,"width":0.8117399999999999,"height":0.17179}},{"text":"Address: _________________________________________________________________________________ \n Check One: Single Residence Semi-Detached Apartments \n Number of Dwelling Units_____ Property Vacant: Yes No \n CURRENT OWNER INFORMATION:","bbox":{"left":0.094118,"top":0.445133,"width":0.806663,"height":0.0952369999999999}},{"text":"Owner’s Name: __________________________________________________________________________ \n Owner’s Address: ________________________________________________________________________ \n City: _______________________State: ______Zip: ___________ Phone:( ) ______________________ \n Anticipated Date of Settlement:____________________ Lock Box #:____________________","bbox":{"left":0.094118,"top":0.549704,"width":0.810736,"height":0.09360599999999997}},{"text":"Person to contact to schedule inspection: ______________________Phone #___________________ \n __________________________________ \n Signature \n ________________________________________ _____________________________________________ \n Print Name Date","bbox":{"left":0.094118,"top":0.660461,"width":0.8105479999999999,"height":0.109819}},{"text":"FEE CALCULATION: \n # of units____ x $75.00 per unit(if received 14 days or more prior to closing) = _____Total due","bbox":{"left":0.094118,"top":0.785795,"width":0.795755,"height":0.03558299999999992}},{"text":"# of units____ x $125.00 per unit(if received less than 14 days prior to closing) = _____Total due","bbox":{"left":0.094118,"top":0.838378,"width":0.808513,"height":0.017090999999999967}},{"text":"FOR OFFICE USE ONLY Inspection Fee Paid: $________Cash_______Check:________ Date:_________ \n Payment submit by: _______________________________________________________________________________","bbox":{"left":0.094118,"top":0.874441,"width":0.805056,"height":0.030873999999999957}}],"images_bbox":[],"images_bbox_not_text_overlap":[]}