JEDD RENTAL QUESTIONNAIRE                                                                   TAX OFFICE USE ONLY

JOINT ECONOMIC DEVELOPMENT DISTRICTS                                        Date Issued
                                                    BATH-AKRON-FAIRLAWN JEDD
1 Cascade Plaza Suite 100                           COPLEY-AKRON JEDD       Auditor ______________________
Akron, OH 44308                                     COVENTRY-AKRON JEDD
                                                                            Account#
(330) 375-2539  Fax (330) 375-2456                  SPRINGFIELD-AKRON JEDD

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 JEDD Income Tax Return before, what name and account number did you use?
NAME USED                                                                   ACCOUNT NUMBER

If you or your company are a JEDD resident, list below all of the rental properties you own. If you are not a JEDD resident, list
only those properties which are located in the JEDD.

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 the JEDD?              ( 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

                                                                                                     2/1/2022