2. This form is required to be completed annually by residential rental property owners. This form will accept up to five addresses. Submit multiple forms if necessary.
4. To avoid penalty, registrations are due by May 1, annually.
6. Owner Information
8. Name*
10. Address*
12. City*
13. State*
14. Zip*
16. Contact Number*
17. Alternate Contact Number
18. E-mail Address
20. Property Manager Information
22. Are the owner and Property Manager the same?*

    1. Yes
    2. No
24. Name of Property Manager*
26. Address*
28. City*
29. State*
30. Zip Code*
32. Contact Number*
33. Alternate Contact Number
34. E-mail Address
36. Primary Contact Name (Property Owner/Property Manager)*
38. Rental Property Address Information
40. Property Address*
41. Total Number of Units at Property*
43. Date of Last Inspection*
    If not yet inspected, write "none"
44. New Registration?*

    1. Yes
    2. No
45. Add a 2nd Address?*

    1. Yes
    2. No
47. Property Address #2*
48. Total Number of Units at Property*
50. Date of Last Inspection*
    If not yet inspected, write "none"
51. New Registration?*

    1. Yes
    2. No
52. Add a 3rd Address?*

    1. Yes
    2. No
54. Property Address #3*
55. Total Number of Units at Property*
57. Date of Last Inspection*
    If not yet inspected, write "none"
58. New Registration?*

    1. Yes
    2. No
59. Add a 4th Address?*

    1. Yes
    2. No
61. Property Address #4*
62. Total Number of Units at Property*
64. Date of Last Inspection*
    If not yet inspected, write "none"
65. New Registration?*

    1. Yes
    2. No
66. Add a 5th Address?*

    1. Yes
    2. No
68. Property Address #5*
69. Total Number of Units at Property*
71. Date of Last Inspection*
    If not yet inspected, write "none"
72. New Registration?*

    1. Yes
    2. No
73. Additional Addresses?*

    1. Yes
    2. No

    If yes, submit an additional form.
75. Registration Fees
    Registration fees of $10 per unit for new registrations will be required to complete registration. Contact the Building & Planning Department at 641-236-2600 to discuss payment options for new registrations.
77. As long as the property has not changed owners, annual renewals will be done at no charge. If a property has been sold and remains a rental unit it will be considered a new registration and subject to a registration fee.
79. As the property owner (or owner's representative), I understand that I am subject to the rental regulations of the City of Grinnell, including but not limited to the right of the City to perform inspections on my property as part of the rental requirements. I understand that it is my duty to notify my tenants of any upcoming inspections and to either be present or have a representative that is at least 18 years of age present during the inspection. By my signature below, I am certifying that the rental units identified in this form comply with City of Grinnell Rental Property Code, as summarized in the Rental Inspection Checklist.
81. Electronic Signature of Owner or Owner's Representative*
83. Date*
    Date
Leave This Blank:


85. 1. Receive an email copy of this form.
86. Email address

    This field is not part of the form submission.

87. Submit Submit and Print

* indicates a required field