RENTAL QUESTIONNAIRE                                                       TAX OFFICE USE ONLY 

    INCOME TAX DIVISION                                                        Date Issued 
    1 Cascade Plaza - Suite 100                                                Auditor_______
 Akron, OH 44308 -1161
    (330) 375-2290 Fax (330) 375-2112                                          Account No 

The following information is necessary for our records. PLEASE COMPLETE AND RETURN THIS QUESTIONNAIRE WITHIN TEN (10) DAYS. 

                                                                               Note:      If you manage or supervise 
                                                                               rental properties please  complete 
                                                                               the name  and address lines below, 
                                                                               which identifies the owner(s) of the 
                                                                               property. Owners need to complete 
                                                                               the entire questionnaire. 

OWNER’S NAME                                                                   SOC SEC # 
SPOUSE’S NAME                                                                  SOC SEC # 
OWNER’S ADDRESS 

DAYTIME PHONE                                      BEST TIME TO CALL 

BUSINESS NAME                                                                  FED  ID #  

BUSINESS  ADDRESS  

If you have filed a City of Akron Income Tax Return before, what name and account number did you use? 
NAME USED                                                                      ACCOUNT NUMBER 

If you are an Akron resident, list below all of the rental properties you own. If you are not an Akron resident, list only those 
properties which are located in the City of Akron. 

    Street Address                                       Date Acquired         Number of Units        Gross Monthly Rents 

List any additional properties on the back of this form. 

How many people do you employ in Akron?                  (Include building managers, custodial, maintenance, secretarial, etc.) 

Under penalties of perjury, I certify that all information and statements herein (both front and back) are true and correct. 

Print Name 

Signature                                                                      DATE 

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