What is the Individual Registration Form for?

It collects information for an individual registering with a city or village, including residence, employment, income, and rental-property details.

Who completes this registration form?

The primary registrant completes the form. It also requests spouse information when applicable.

How do I submit the Individual Registration Form?

Mail it to RITA’s Registration Department at the address printed on the form, or fax it to 440.526.3136.

Do I need a notary for the Individual Registration Form?

No. The form does not require notarization and lists no sworn attachment or related notarized step.

Jackson Center, OH · Shelby County

No notary required

Individual Registration Form

This form registers an individual with the city or village and is completed by the primary registrant, with information about a spouse when applicable.

What this form is

The Individual Registration Form is for registration with the city or village and is addressed to the Regional Income Tax Agency’s Registration Department. It asks for the registrant’s and spouse’s identifying and residence details, employment and retirement information, and information about income and rental property. Renters are also asked for their landlord’s details, and rental property owners provide tenant and rental-start information.

Who needs it

Individuals registering for the listed city or village complete the form and provide spouse, residence, employment, and rental-property information when applicable.

How to submit it

Mail the form to RITA, Attn: Registration Dept., P.O. Box 477900, Broadview Heights, OH 44147-7900, or fax it to 440.526.3136.

About notarization

No notary is required; the form lists no sworn attachment or related notarized step, and asks the registrant to provide the requested information.

How to submit this form

1
Download the Form
Download the Individual Registration Form PDF.
2
Complete the Form
Fill in the requested identifying, residence, employment, income, and rental-property information that applies.
3
Gather Rental Details
If you own rental property, provide tenant names and addresses and the date renting began; use the back or a separate sheet for multiple properties.
4
Submit to RITA
Mail the form to the Registration Department address printed on it, or fax it to 440.526.3136.

Frequently asked questions

What is the Individual Registration Form for?: It collects information for an individual registering with a city or village, including residence, employment, income, and rental-property details.
Who completes this registration form?: The primary registrant completes the form. It also requests spouse information when applicable.
How do I submit the Individual Registration Form?: Mail it to RITA’s Registration Department at the address printed on the form, or fax it to 440.526.3136.
Do I need a notary for the Individual Registration Form?: No. The form does not require notarization and lists no sworn attachment or related notarized step.

Need something notarized?

This Individual Registration Form doesn’t need a notary — but if you have another Jackson Center form that does, a commissioned online notary can help.