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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 616-527-0146. 

   For questions regarding this form, please email Daniel Davis or call 616-523-0158.

   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: Single-Dwelling Unit $50, Duplex (Two-Dwelling Units) $100, Additional Dwelling Units (3+) +$25 per additional dwelling unit. 

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
22. Short-Term Rental (Renting or leasing of a dwelling unit between 1 night and 27 nights)

    1. Yes

    1. No

26. Owner Information

28. I acknowledge that it is my responsibility to schedule an appointment for a housing inspection and to complete all repairs necessary for the issuance of a “Certificate of Compliance” pursuant to Chapter 858 of the City Code; that it is my responsibility to schedule any necessary reinspection in order to receive the Certificate of Compliance; and that I have reviewed and understand the requirements within the Rental Registration Program outlined in Chapter 858.

30. Owner Name*
34. Owner Home Address*
36. City*
37. State*
38. Zip Code*
40. Owner Phone*
41. Owner Email Address*
43. 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.

45. Enter Owner Name as Signature*

    You certify that the foregoing is accurate.

46. Today's Date*
    Today's Date

50. Agent Information

52. Owners may act as their own agent if they reside in Ionia County or within a 30-mile radius of the dwelling unit; otherwise, they must designate a local agent.

    If the owner is not acting as own agent, the following person has been designated as agent pursuant to 858.01 (a) of the Ionia City Code, and understands that, as local agent, they are responsible for ensuring compliance with the City Code on behalf of the owner. 

54. Agent Name
56. Agent Mailing Address
58. City
59. State
60. Zip Code
62. Agent Phone
63. Agent Email Address
65. Enter Agent Name as Signature

    You certify that the foregoing is accurate.

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


68. 1. Receive an email copy of this form.
69. Email address

    This field is not part of the form submission.

70. Submit

* indicates a required field