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

Form Rf-I - City Of Sharonville Registration Form

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CITY OF SHARONVILLE REGISTRATION FORM

Print Form

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

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

Account #:

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

Resident Name

Birth Date

SS#

Resident Name (Spouse)

Birth Date

SS#

Sharonville Address

Apt

Phone #

Listed

Unlisted

Mailing Address

Move-In Date

Move-Out Date

EMAIL Address

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

RESIDENT

RESIDENT (SPOUSE)

Name of Employer

Employment Location

Employment Date

Occupation

List all cities for which taxes are withheld

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, a copy of a recent pay stub or W-2 should be included with this registration form.

EMPLOYMENT

CITY EARNINGS

EMPLOYER ADDRESS

NAME

DOB

SS#

EMPLOYER

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 08/09

Form Rf-I - City Of Sharonville Registration Form

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