City of Owosso Rental Registration Form
301 W Main St Owosso, MI 48867
989-725-0540
$50.00 Registration Fee PER non-MSHDA UNIT
TYPE OF APPLICATION (check all that apply):
□ New
□ Renewal
□ Change of Owner
□ Change of Agent
MSHDA Unit(s) __YES __NO # of MSHDA Units____
Required to submit MSHDA Inspection Reports
RENTAL PROPERTY INFORMATION:
Property Address:
Parcel Tax ID #:
Type of Rental:
□ Single family
□ Duplex (2-family)
□ 3 + units (multi-family)
# of dwelling units:
# of off street parking spaces:
# of private entrances:
# of units occupied:
# of units owner occupied:
# of units occupied by a family member:
How are the rental units identified (100, 100 ½, #1, #2, A, B, etc.):
Name of complex:
# of buildings in complex:
# of units per building:
OWNER INFORMATION:
Name:
Company Name:
Address:
City, State, Zip Code
Cell Phone Number:
Email:
OWNER’S REPRESENTATIVE/PROPERTY MANAGER/AGENT:
Name:
Company Name:
Address:
City, State, Zip Code
Cell Phone Number:
Email:
Send Correspondence to:
□ Owner
□ Property Manager
Send Billings to:
□ Owner
□ Property Manager
Contact for Inspections:
□ Owner
□ Property Manager
I hereby affirm that the reported information regarding the residential rental dwelling unit(s) listed above are true to the
best of my knowledge. I understand that failure to register any residential dwelling unit(s) located within the City of
Owosso may result in a fine and/or a civil infraction in accordance with the provisions of City Ordinance No. 704.
Signature:
Date: