Landlord Tenant Report Form - City Of Fairfield

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City of Fairfield
LANDLORD TENANT REPORT
Landlord Name: ______________________
Address:_______________________________
Phone Number _______________
Complete a form for each rental property located within the City of Fairfield and remit to the address listed below within thirty (30)
days of the tenant move in or out date. If tenant is moving out, provide a forwarding address when available.
Full Name of Tenant
Complete/Forwarding Address (including Apt #)
Date In
Date Out
Phone Number
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If additional forms are needed, contact our office at the number listed below or visit our web site at
INCOME TAX DIVISION
5350 Pleasant Avenue, Fairfield, Ohio 45014 513-867-5327 (TDD-867-5392)

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