Dear Blue Ash Resident: 
 
In  order  to  establish  or  update  your  account,  we  need  some  basic  information.    Prompt 
completion of the attached form could prevent delays in receipt of the great amenities provided by 
the City including recreation membership. 
 
Helpful tips for completing the registration: 
 
   Please be thorough and fill in all information requested.  Use “n/a” for any information that 
   does not apply. 
 
  List all people living at this address.  This includes children, relatives, roommates, etc.  
   If  anyone  listed  is  not  employed  please  note  in  the  employer  field  (retired,  child,  on 
   disability,  temporarily  unemployed,  etc.).    Note:  all  individuals  18  and  older  need  to 
   establish their own account and will need to complete a separate registration. 
 
Other useful information: 
   The City of Blue Ash has an income tax of 1.25%. 
   The City offers credit for taxes paid to other cities up to 1.25% of the related income. 
   Annual returns are required to be filed by every resident who is 18 years and older.  Those 
   under 18 are only required to file if there is a liability. 
 
The Blue Ash Tax Division would be pleased to assist you with any questions.  We are available 
Monday through Friday, 8:00 AM to 5:00 PM.  Additionally, information and forms can be found at 
www.blueash.com/departments/tax_office. 
 
Please  return  the  completed  registration  within  thirty  (30)  days.    A  return  envelope  has  been 
included  for  your  convenience.  Please  note  that  your  information  will  remain  confidential  as 
required by Ohio law. 
 
Thank you in advance for your cooperation. 
 
Sincerely, 
 
Blue Ash Income Tax Division 
 

City of Blue Ash                                                                                                                        Income Tax Division 
4343 Cooper Road - Blue Ash, Ohio 45242-5699                                                                    Phone: (513) 745-8516; Fax: (513) 745-8651 
www.blueash.com                                                                                                 Or Email Address:  blueashtax@blueash.com 
                   CITY OF BLUE ASH CONFIDENTIAL RESIDENT REGISTRATION 
 
ADDRESS ___________________________________________________________        PHONE NO. ___________________                            ACCT. NO. ________________ 
  House No.        Street                            Apt. #    Zip Code                                                                         (Office Use Only) 
 
YOUR NAME________________________________     SOCIAL SECURITY NO. ____________________________                  MOVE-IN DATE ___________________ 
EMPLOYER ___________________________________            ADDRESS WHERE YOU WORK ___________________________________________________ 
Do you pay earnings tax to a city? _________  If so, what city? ______________________                       Date present employment began __________________________ 
Do you or does anyone in your household receive a refund from your city of employment? ___________  If so, who? _____________________________________ 
Do you or your spouse have business income? ___________ In Blue Ash? _______________                          Where? _______________________________________ 
 
SPOUSE’S NAME ____________________________  SOCIAL SECURITY NO. ___________________________                     MOVE-IN DATE ___________________ 

EMPLOYER __________________________________  ADDRESS OF EMPLOYMENT ___________________________________________________________ 

Does spouse pay earnings tax to a city?________  If so, what city? _____________________      Date present employment began __________________________ 
 
NOTE:  LIST BELOW ALL OTHER OCCUPANTS (children, relatives, roommates, etc.).  USE ADDITIONAL PAPER IF NECESSARY. 
 
  Name             Relationship               Date of Birth   Employer (if appl)                             Address of Employment   Date Began City Taxes? Where? 
                                                                                                                                                 
Note: Individuals 18 or over will need to establish their own account and complete a separate registration.   Info/forms can be found at:  www.blueash.com/departments/tax_office 
 
If you rent, provide name and address of landlord _______________________________________________________________________________________________ 
If any member of your household owns rental property, provide name of owner________________________________________________________________________ 
 Address of rental property ___________________________________________________________                        Date acquired for rental ________________________ 
 Name of current tenant (if property located in Blue Ash) ___________________________________ 
 
I hereby certify that to the best of my knowledge the above information is true, correct, and complete. 
SIGNATURE _____________________________________         Date _______________________                          Email _______________________________ 

Please return completed form to:  Blue Ash Tax Division, 4343 Cooper Road, Blue Ash, OH 45242-5699 or fax to (513) 745-8651. 
If any of the above information changes, you are required to notify us within thirty (30) days.             Thanks for your cooperation                                 Updated  7-2016