JEDD RENTAL QUESTIONNAIRE                                                    TAX OFFICE USE ONLY

JOINT ECONOMIC DEVELOPMENT DISTRICTS                                         Date Issued
P.O. BOX 80538                                      BATH-AKRON-FAIRLAWN JEDD Agent/Auditor
Akron, OH 44308                                     COPLEY-AKRON JEDD
                                                    COVENTRY-AKRON JEDD
(330) 375-2539(330) 375-2039 Fax (330) 375-2112     SPRINGFIELD-AKRON JEDD   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 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

1)
2)
3)
4)
5)
6)
7)

  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

                                                                                                      8/97