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Lease Info

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Lease Start Date

Facility Location:
322 Storage
138 Yearicks Blvd.
Centre Hall, Pennsylvania 16828

Available Unit Sizes

Name

Email

Business Contact Name If you are a business, please enter a contact name.

Phone Numbers

Primary?

Country

Address Line 1

Address Line 2

City

State / Province

Postal Code

Driver's License Number

Initials

Alternate Contact - Name

Alternate Contact - Address

Alternate Contact - Phone

Type of Goods Stored

Approximate Value of Goods

Insurance Options

Purchase SafeStor Tenant Insurance

Provide Proof of Insurance Coverage

Request Proof of Insurance Coverage Be Waived

Interested in SafeStor Insurance?

$1,000 Coverage - $7.95 Per Month

$5,000 Coverage - $10.95 Per Month

$10,000 Coverage - $20.95 Per Month

$15,000 Coverage - $35.95 Per Month

Not Interested

Insurance Agent's Name

Insurance Agent's Phone

Deductible Amount

Insurance Policy #
Review & Sign

Review the lease agreement and sign.
Pay

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