TENANT INFORMATION: The names of all occupants who reside in this dwelling and their relationship to any other persons residing in the dwelling (if no relationship, state “none”) are as follows:

Name
Relationship
Unit #/Date of Occupancy
Name
Relationship
Unit #/Date of Occupancy
Name
Relationship
Unit #/Date of Occupancy
Name
Relationship
Unit #/Date of Occupancy

TENANT CONTACT PHONE NUMBER: (NOT the landlord’s phone number; please provide a number the City can use to contact property occupants directly in case of emergency or other problem)

Please note: By signing this form, you acknowledge the following:

  1. 1) This form is required by law and is being submitted to obtain an Occupancy Certificate.
  2. 2) You understand that the Oakwood Property Maintenance Code requires you to submit a NEW Tenant Information Form each time there is a change of tenant(s) in your rental premises.
  3. 3) You understand that knowingly making a false statement on this Tenant Information Form is a violation of the Ohio Revised Code: Section 2921.13 (A) which is a first-degree misdemeanor punishable by a fine of up to $1,000 and/or up to 6 months in jail.
Signature
Printed
Date