Property Owner Information:

Last Name
First Name(s)

Kildare Property Address:
Fire # Street Name

If vacant land or no fire #, please describe street location or the nearest fire number to your property: 

Mailing Address (if other than above):
Address:
    City:  
  State:   Alabama Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington D.C. Washington State West Virginia Wisconsin Wyoming Alberta British Columbia Manitoba New Brunswick Newfoundland Northwest Territories Nova Scotia Nunavut Ontario Prince Edward Island Quebec Saskatchewan Yukon Other         Zip:

Phone: (999-999-9999)

Email Address:           

Retype Email Address:

May we contact you via email? :  Yes     No

Property Purchase Date:  Select One 2007 2006 2005 2004 2003 2002 2001 2000 1999 1998 1997 1996 1995 1994 1993 1992 1991 1990 1989 1988 1987 1986 1980-1989 1970-1979 1960-1969 1950-1959 1940-1949 1930-1939 1920-1929 Before1920 Other

Primary Use of Land: (You may select as many as apply to you.)
Residential
Agricultural
Small or Home-Based Business
Land Investment
Recreational (Hunting, fishing, camping, etc.)
Other: 

To help us plan for future growth in the Town of Kildare:

Are you a:  Full-Time Resident Seasonal Resident - 3 mos./year or more Weekends/Vacations Resident

If you are not currently a resident, do you intend to live in Kildare full-time sometime in the future?
No          Yes          When? Within 2 years Within 5 years Within 10 years Within 15 years Within 20 years More than 20 years from now

Please double check your answers before clicking the Submit Button!