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 JEDD   BUSINESS   QUESTIONNAIRE                                                                                                                                                                                           TAX  OFFICE  USE  ONLY 
 JOINT  ECONOMIC  DEVELOPMENT  DISTRICTS 
                                                                                                                                                                                                                            ÅÅAccount#  ______________
   1 Cascade Plaza - Suite 100 
                                                                                                                                                                                                                             Account#  ______________
         Akron, OH 44308-1161                                                                                                                                                                                                Auditor  ________________
 (330) 375-2539 - Profit/Loss                                                                                                                                                                                                Date Issued_____________
 (330) 375-2497 - Withholding 
 (330) 375-2456 - Fax
___________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________  ___________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________  
The following information is necessary for our records.    PLEASE COMPLETE AND RETURN THIS QUESTIONNAIRE WITHIN TEN (10) DAYS. 

                                                                                                                                                                                                                        BATH-AKRON-FAIRLAWN JEDD                                                                                                                                                                                                       
                                                                                                                                                                                                                        COPLEY-AKRON JEDD                                                                                                                                                                                                              
                                                                                                                                                                                                                        COVENTRY-AKRON JEDD                                                                                                                                                                                                            
                                                                                                                                                                                                                        SPRINGFIELD-AKRON JEDD                                                                                                                                                                                                         

BUSINESS NAME_____________________________________________________________________________________________________________
BUSINESS ADDRESS _________________________________________________________________________________________________________                                                                                                                                                                                                                                                                                                                                                                                                     
 (Mailing address for tax purposes)
BEGINNING  DATE  OF  JEDD ACTIVITY__________________________________________________                                                                                                                                         TELEPHONE  # _________________________                                                                                                                                                                                                                                                            
JEDD  ADDRESS _____________________________________________________________________________________________________________ 
JEDD  TELEPHONE  # _______________________________                                                                        IS JEDD  THE  HOME  OFFICE?________________   BRANCH  OFFICE? ___________                                                                                                                                                                                                                                                          
If  no JEDD address,  are  any  net  profits  attributable  to  the JEDD?       YES_____    NO __                                                                                                 _             ____

TRADE  NAME (if any)________________________________________________________  FED  ID # ________________________________________ 
FEDERAL BUSINESS ACTIVITY CODE _____________                                                                                                    NATURE  OF  BUSINESS _______________________________________________________
                          TYPE  OF  ORGANIZATION :   Sole Proprietorship_____                                                                                        __ S Corp ______             __     C Corp ____   __ __      Partnership ___                                                                                                                                                           __ __         _    LLC  ________

 __________________________________________________________________________________________________     OWNERS     NAME                                                                                                     ADDRESS                                                                                                                                                                                                                                                                    SOC     SEC     NUMBER 
 __________________________________________________________________________________________________  OWNERS     NAME        ADDRESS                                                                                                                                                                                                                                                                                           SOC     SEC     NUMBER    
NUMBER   OF  EMPLOYEES  WORKING  IN  JEDD _____________    DATE  FIRST  EMPLOYEE  WAS  HIRED________________________________

ACCOUNTING  PERIOD  USED:                                                                                                 CALENDAR  YEAR _______                                     FISCAL  YEAR _______          (Fiscal   Year  Ending _________)

Do  you own  rental  property  in the JEDD?    YES __                                                                                 ___  NO ___                    ___        (If yes,  what is the total annual  gross  income? _______________________ )
            Address ____________________________________________________________________    Date  Purchased ______________________________
      Address ____________________________________________________________________    Date  Purchased ______________________________                                                                                                                                                                                                                                                                                                                                                                                           
Do you operate more than one place of business in the JEDD?      YES                                                                                                        _______ NO ___             ____
            Address ____________________________________________________     Trade  Name ________________________________________________
            Address ____________________________________________________     Trade  Name ________________________________________________
IF  CURRENT  BUSINESS  IS  THE  SUCCESSOR  TO  A  PRE-EXISTING  BUSINESS,  PLEASE  COMPLETE  THE  FOLLOWING:

Name/s     of  previous  owner/s  and  trade  name,  if  any _______________________________________________________________________________
 ___________________________________________________________________________________________________________________________
Mailing  Address ______________________________________________________________________________________________________________

Former  Business  Type :                                   Sole Proprietorship _____                                                  S Corp___                                ____      C Corp __          __ __ _    Partnership ___     ____    LLC _                                                                                                                                                                    ______

___________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ ___________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ Under penalties of perjury,  I certify that all information and statements herein are true and correct. 

Print  Name & Title ___________________________________________________________________________________
Signature __________________________________________________________   Date __________________________

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