Las Vegas Self Storage

	Desired Date*
Note:Up to 30 days in advance only.	( * required fields)
4490 East Lake Mead Blvd
(702) 459-6646
	Last Name, First Name and MI*
	Current Street Address*
	City, State and ZipCode *
	Phone Number with Area Code*
	Driver License Number & State *
	last 4 digits of your Social Security Number *
	E-mail Address *
Company Information	(if for business use)
	Company Name
	Business Street Address
	City, State and Zip Code
	Business Phone with Area Code
Nearest Friend or Relative
	Relative or Friend Name *
	Current Street Address *
	City, State and Zip Code *
	Phone Number with Area Code *
Person with Access to Unit
	Access Name *
	Phone Number with Area Code *
	Access Name
	Phone Number with Area Code

*A brief description of contents being stored

Are there any any liens on anything being stored?	Yes No

If yes above, describe

*Check all that apply.	Business Tax Exempt (must show proof) Military (active) Military (reserve) I have read the military form (view here).
*What size do you need ?
*What is your estimated time of stay?
How did you hear about us?
	Notes or comments



	I HAVE READ AND UNDERSTAND THE ABOVE RULES AND RENTAL AGGREMENT AND I AGREE TO THESETERMS:
	I understand there are no refunds for any reason.
	I understand that I am storing at my own risk and will provide my own insurance.
	I understand that I need to submit a 15 day notice to vicate prior to terminating my lease.
	I understanding that I am renting this unit now, and will be given a security code when documents are signed in person.
	All of the above must be checked off prior to clicking submit.

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