Form Rf-I - Individual Registration Form - City Of Sharonville printable pdf download

Form Rf-I - Individual Registration Form - City Of Sharonville

CITY OF SHARONVILLE REGISTRATION FORM

City of Sharonville • Income Tax Office • 11641 Chester Road • Sharonville, OH 45246-2803

Phone: (513) 563-1169 • FAX: (513) 588-3969 •

ALL INFORMATION PROVIDED WILL REMAIN CONFIDENTIAL. RETURN COMPLETED FORM IN ENCLOSED ENVELOPE WITHIN 10 DAYS.

Resident Name

SS#

Resident Name (Spouse)

SS#

Sharonville Address _______________________________________________________Apt ____ Phone # ________________________Listed _____ Unlisted _____

Mailing Address _________________________________________________________________Move-In Date _______________ Move-Out Date _______________

EMPLOYMENT INFORMATION (Attach current pay stub and/or copy of W-2)

RESIDENT

RESIDENT (SPOUSE)

Name of Employer

Address of Employer

Employment Date

Occupation

City Earnings Tax Paid To

LIST BELOW ALL OTHER OCCUPANTS OF HOUSEHOLD REGARDLESS OF EMPLOYMENT STATUS. USE ADDITIONAL PAPER IF NECESSARY.

If anyone listed below pays City taxes through their employer, you must include a copy of a recent pay stub or W-2 with this registration form.

EMPLOYMENT

CITY EARNINGS

NAME

AGE

SS#

EMPLOYER

EMPLOYER ADDRESS

DATE

TAX PAID TO

If you rent, give name and address of landlord ________________________________________________________________________________________________

If you or any member of your family owns rental property, please list the following:

Name of owner of rental property: _________________________________________________________________Date acquired for rental: ____________________

Address of rental property: _________________________________________________________ Name of current tenant: ___________________________________

(If property located in Sharonville)

I do hereby certify that to the best of my knowledge the above information is true, correct and complete.

Signature

Date

Form RF-I REV 11-03

Form Rf-I - Individual Registration Form - City Of Sharonville