Rent Stabilization Association: Membership Application

Please note: RSA membership dues are based on a calendar year (January - December)

1. CHECK ONE

	New Account
	Associate Member
	Transfer of Ownership
	Coop

2. PROPERTY INFORMATION (For Regular Membership)

Street Address:

Boro/Town:

City: State: Zip:

Total Apartments in Building: Stabilized Apartments:

MDR#: BLOCK#: LOT#:

3. AGENT INFORMATION (Address for Mailing Purposes)

Name:

Company:

Title:

Address:

City: State: Zip:

Phone:

Fax:

Email address:

4. ASSOCIATE MEMBER or OWNER INFORMATION (If different from above)

Name:

Company:

Title:

Address:

City: State: Zip:

Phone:

Fax:

Email address:

5. ADDITIONAL COMMENTS:

Please email, fax or print this application to RSA.

Associate Members:

Please include check or money order payable to RSA in the amount of $100

Regular Membership:

Do not include payment. You will receive a membership statement in the mail based on $5.00 per apartment, $75 per minimum per building.

If you e-mail this application to RSA, we will send you a bill for your annual membership dues and voluntary PAC and Legal Fund contributions. Thank you.

We appreciate your membership and support of the RSA.

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Rent Stabilization Association of NYC, Inc.
123 William Street New York, NY 10038-3804 Tel: (212) 214-9200 Fax: (212) 732-0618