Land Banking Program Application

Contact the Montgomery County Land Bank with questions. Call 937-531-6921, or send an email to info@mclandbank.com.

Sponsoring Community*
Owner's Name*
First Last
Owner's Address*
Street Address Address Line 2 City State ZIP Code
Property Address*
Street Address Address Line 2 City State ZIP Code
Parcel ID #*
Property Type*
Planned Future Use*
Project Name*
Banking Terms
Anticipated Term*
Maintenance Responsibilities (Describe Your Goals for Discussion Purposes)
Applicant*
MDLRC*
Joint*
Provide Copies of Any Title Searches You Have on Properties
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Name*
First Last
Signature*

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