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RENTAL HOUSING INSPECTION PROGRAM REGISTRATION FORM

  1. IMPORTANT MESSAGE

    If you have already submitted a Registration Form by mail or email, DO NOT COMPLETE THIS FORM unless there are changes.

  2. A complete registration form is required annually. It is unlawful for any person to engage in the business of rental housing unless this completed registration form is provided to the City of Citrus Heights, and the annual registration and Housing Stock Fees are paid. A new registration form must be submitted no later than 30 days after a change of owner, agent or rental status. One registration form is required per rental property.

  3. Type of Registration*

  4. Did you complete this form in 2019?

  5. PROPERTY INFORMATION

  6. Type of Dwelling

  7. Property Manager*

  8. **Some rental units may be exempt from this program as determined by and to the satisfaction of the Director of Code Enforcement. If you believe your property or a portion of units whithin is exempt from this program, please complete the Application for Exemption.

    Exempt categories include properties newly constructed within the last five years; units inspected by other government agencies such as Sacramento Housing and Redevelopment Agency (SHRA) or similar; or if the unit(s) is not a "residential housing unit." Complete an Application for Exemption Form at www.citrusheights.net/RHIPExemptionForm if you believe your rental unit is exempt. Supporting documentation is required.

  9. OWNER INFORMATION*

    Are you the Owner?

  10. Attach a copy of the Management Agreement authorizing you to sign on behalf of the owner of the identified property.

  11. Enter your mailing address City and State

  12. Registration forms without an Owner phone number will not be accepted

  13. A Property Manager must be authorized to accept service of all notices from the City of Citrus Heights RHIP and be able to be present for inspections

  14. Tenant Information

    The following information is OPTIONAL. Tenant information is used to contact tenants prior to scheduling an inspection.

  15. ELECTRONIC SIGNATURE AGREEMENT*

    By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.

  16. It is unlawful for any person to knowingly make a false statement of fact or knowingly omit any information that is required to register a rental housing unit (CHMC 50-247)

  17. Leave This Blank:

  18. This field is not part of the form submission.