Skip to form

Ingham County

341 S. Jefferson Street, P.O. Box 319, Mason, MI, 48854, US


Document Signers
    • 1 Applicant Signature


You are now being directed to the Ingham County Environmental Health Point of Sale Application.

Please ensure that all required fields (denoted by an asterisk) are completed and the application digitally signed. 

Once a payment has been made please ensure you click submit (located in the bottom right hand corner of the page) and wait until a pdf of the completed form appears in your browser.​​
Please check that you agree before continuing.
I acknowledge that I have understood these directions and that an application processing delay may occur if they are not followed correctly.
Signature HereClick to Sign
12/13/2018Click to Sign

Create Your Signature

Please fill in your name and email and then either draw or type your signature below.


Signature Type

Type Draw Upload Custom
Clear Signature

Signature will be applied to the page. You will have a chance to review after signing.

Check this box to continue


Additional Signatures Required