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                                                 CITY OF SHARONVILLE REGISTRATION FORM 
                                                 Income Tax Office • 11641 Chester Road • Sharonville, OH  45246-2803  
                                                Phone: (513) 563-1169 • taxoffice@cityofsharonville.com  • www.sharonville.org 
                                                                                                                                        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 
                  NAME                          DOB   SS#                             EMPLOYER               EMPLOYER ADDRESS 
                                                                                                                                                   DATE   TAX PAID TO 
                                                                                                                                                          
  If you purchased the home, give name of Sales Agent                                                        and Listing Agent 
  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 10/22