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- "City of Blue Ash Confidential Resident Registration" - City of Blue Ash, Ohio
"City of Blue Ash Confidential Resident Registration" - City of Blue Ash, Ohio
City of Blue Ash Confidential Resident Registration is a legal document that was released by the Income Tax Division - City of Blue Ash, Ohio - a government authority operating within Ohio. The form may be used strictly within City of Blue Ash.
Form Details:
- Released on July 1, 2016;
- The latest edition currently provided by the Income Tax Division - City of Blue Ash, Ohio;
- Ready to use and print;
- Easy to customize;
- Compatible with most PDF-viewing applications;
- Fill out the form in our online filing application.
Download a printable version of the form by clicking the link below or browse more documents and templates provided by the Income Tax Division - City of Blue Ash, Ohio.
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2Dear 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
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.
Thanks for your cooperation
If any of the above information changes, you are required to notify us within thirty (30) days.
Updated 7-2016
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