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Rental Registration Program Directions <br />Rental Registration Program Form <br />Please complete the Rental Registration Program form. If you are exempt or your property is not a rental <br />unit, submitting this form to the City will remove your name from future mailing lists. The following are <br />di�ections to complete this form. <br />Section 1: Rental Status Identification <br />Check one of the listed options. <br />• If RENTED to a non-relative or non-grou�-home �rovider, go to Section 2 of the form. <br />• If EXEMI'T: Rented to a relative /ste�-relative, go to Section 3 of the form and complete the <br />Affidavit of Exemption. Directions for this form are explained below. <br />• If EXEMPT: Rented to a grou�-home �rovider, go to Section 3 of the form. <br />• If NOT RENTED, go to Section 3 of the form. <br />Section 2: Rental Registration <br />Please fill in all the rental information, property owner information, and property contact information. If <br />information is omitted, City staff will contact you to complete the information prior issuing the Rental <br />Registration certificate. After completing, go to Section 3. <br />Section 3: Property Owner Signature <br />Sign the form and return it to the City of Roseville. If you are required to register, include a check to cover <br />the $25 registration fee. Make checks �aoable to the Citv of Roseville. A Rental Registration certificate will <br />not be issued prior to receiving the requi�ed fee. <br />Affidavit of Exemption <br />Property owners claiming the relative/step-relative exemption from registering their rental property must <br />complete the Affidavit of Exemption. This form must be notarized, which requires completing and signing <br />the document in the presence of a notary public. There are several notary publics at Roseville City Hall who <br />are available to notarize this document at no charge during working hours (8:00 a.m. to 4:30 p.m.). If you <br />cannot make it to City Hall, contact your local bank or post office to see if they have someone on staff <br />certified as a notary public. After completing, please return this form to the City of Roseville. <br />Form Submission <br />Return your completed form(s) to: <br />Community Development Department <br />Attn: Rental Registration <br />City of Roseville <br />2660 Civic Center Dr. <br />Roseville, MN 55113 <br />OR <br />FaY: (651) 792-7070 <br />Email: rentalhousing�a��tvofroseville.com <br />Questions <br />Please telephone (651) 792-7016 or email your questions to rentalhousing�a��vofroseville.com. <br />City of Koseville June 2009 <br />