74 Montcalm Street (Former Agway) Purchase Application

74 Montcalm Street (Former Agway) Purchase Application

Complete this application to express your purchase interest for 74 Montcalm Street—submission is date/time-stamped and does not guarantee selection or sale.
Applicant Full Name

First NameLast Name
Business/Entity Name (if applicable)
Mailing Address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Email Address
example@example.com
Brief Proposed Use of the Property
Estimated Timeline to Begin Improvements/Development After Closing
Required Acknowledgement: I understand that I am responsible for selecting and retaining my own attorney and, if desired or required, my own real estate agent. The Essex County Land Bank does not represent me in this transaction.
Required Certification: I certify that the information provided in this application is true and complete. I understand that submission of this application does not guarantee selection or sale of the property.
Typed Signature / Full Legal Name
Application Submission Date & Time

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Hour MinutesAM/PM Option
I certify that I have proof of funds or financing sufficient to support my proposed purchase and understand that proof of funds or financing/pre-qualification documentation will be required before a formal offer is considered.
I certify that, within the past five (5) years, I have not been subject to a tax foreclosure, mortgage foreclosure, or blighted property citation involving any commercial property that I owned or controlled.
Should be Empty: