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2. This form needs to be resubmitted whenever the owner and/or agent information changes. All owners should verify with the City Assessor that the owner's address is up to date by calling 616-527-4170, ext. 5146. 

   For questions regarding this form, please email Royal Shilton or call 616-523-0157.

   Please note: By submitting this form, the owner/agent acknowledges that they have read the city's "residential property ordinance".

4. Purpose of Application

   1. New Rental Registration
   2. Change of Address/Phone
   3. Change of Ownership
   4. Change of Agent
   5. Existing Rental

6. Fees: Up to 3 units, $25 each; 4 or more in the same building, $15 each.

10. Property Information

12. Legal Property Address*

    Per Assessing Records

14. Property Street Address*
16. Exemptions

    If applicable

17. Total Units*

    The number includes any owner-occupied or vacant units.

19. Rental Units*

    Number of rental units.

20. Date Property Became Rental*
    Date Property Became Rental

24. Owner Information

26. By submitting this application, you acknowledge that it is your responsibility to schedule an appointment for a housing inspection and to complete all repairs necessary for the issuance of a "Certificate of Compliance" issued pursuant to Chapter 858 of the City Code; that it is your responsibility to schedule any necessary re-inspections in order to receive the Certificate of Compliance; and that you understand the information on the Rental Registration Program. (Owners may act as their own agent if they live in the approved local area, otherwise, they must designate a local agent.)

28. Owner Name*
30. Owner Home Address*
32. City*
33. State*
34. Zip Code*
36. Owner Phone*
37. Owner Email Address*
39. Are You Acting as Your Own Agent?*

    1. Yes
    2. No

    If Yes, and you want to use a different mailing address (i.e. P.O. Box), please fill out the "Agent Information" section. If No, please designate a local agent in the "Agent Information" section.

41. Enter Owner Name as Signature*

    You certify that the foregoing is accurate.

42. Today's Date*
    Today's Date

46. Agent Information

48. The following person has been designated as an agent pursuant to 858.02A5 of the Ionia City Code and understands that, as a local agents, they are responsible for ensuring compliance with the City of Ionia Housing Code on behalf of the owner.

50. Agent Name
52. Agent Mailing Address
54. City
55. State
56. Zip Code
58. Agent Phone
59. Agent Email Address
61. Enter Agent Name as Signature

    You certify that the foregoing is accurate.

62. Today's Date
    Today's Date
Leave This Blank:


64. 1. Receive an email copy of this form.
65. Email address

    This field is not part of the form submission.

66. Submit

* indicates a required field