Resident Registration Questionnaire Template - City Of Reading, Ohio - Income Tax Bureau Page 2

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EMPLOYMENT INFORMATION (Cont.)
YOU
SPOUSE
PREVIOUS EMPLOYER: ______________________________
PREVIOUS EMPLOYER: ______________________________
ADDRESS: __________________________________________
ADDRESS: __________________________________________
# YEARS WORKED: _________________________________
# YEARS WORKED: _________________________________
PROPERTY INFORMATION
4. DO YOU OWN THE PROPERTY IN WHICH YOU LIVE:
YES______ NO ______
IF “NO” ARE YOU RENTING?
YES______ NO ______
LIST NAME AND ADDRESS OF LANDLORD: ______________________________________________________________
_______________________________________________________________________________________________________
5. DO YOU OWN RENTAL PROPERTY (S) IN READING?
YES______ NO ______
ADDRESS(ES) OF RENTAL PROPERTY (S) IN READING:

TYPE PROPERTY: ____ SINGLE FAMILY ____ DUPLEX ____ APARTMENT ____ TRAILER ____ COMMERCIAL

TYPE PROPERTY: ____ SINGLE FAMILY ____ DUPLEX ____ APARTMENT ____ TRAILER ____ COMMERCIAL
DO YOU OWN RENTAL PROPERTY (S) OUTSIDE READING?
YES______ NO ______
ADDRESS(ES) OF RENTAL PROPERTY (S) OUTSIDE READING:


6.
OTHER HOUSEHOLD MEMBERS
Please List ALL Members 18 Years and Older Living In Your Residence
NAME
D.O.B.
SOCIAL SECURITY #
EMPLOYER NAME (If Applicable)
_______________________________________________________________________________________________________________
_______________________________________________________________________________________________________________
_______________________________________________________________________________________________________________
_______________________________________________________________________________________________________________
7. IF REGISTERING FOR READING SCHOOLS, PLEASE ATTACH COPY OF LEASE OR LETTER FROM LANDLORD.
NAME(S) OF CHILDREN:______________________ ___________________________________________________
NAME OF SCHOOL(S) THEY WILL ATTEND:_____________________________________________________________________
I CERTIFY THAT THE ABOVE INFORMATION IS TRUE AND ACCURATE TO THE BEST OF MY KNOWLEDGE.
___________________________________________
______________________________
Signature
Date
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