Name: _____________________________________________________________________________________

Address: ___________________________________________________________________________________

Phone: _____________________________________________________________________________________

Is this property a: single multiple rental business

How many years did you or have you lived at this address? _____________________________________________

Give a brief description of this house or business: _____________________________________________________

___________________________________________________________________________________________

___________________________________________________________________________________________

Please describe any unique or historical features of the house such as design or architectural features, floor plans,

woodwork or other features you think interesting. _____________________________________________________

___________________________________________________________________________________________

___________________________________________________________________________________________

Has flood or fire ever damaged this house? Please explain. _______________________________________________

___________________________________________________________________________________________

___________________________________________________________________________________________

Describe any additions or alterations to the house or property. ___________________________________________

___________________________________________________________________________________________

___________________________________________________________________________________________

Does this house have a nickname? ________________________________________________________________

___________________________________________________________________________________________

Do you know any legends or stories connected to this house? ___________________________________________

___________________________________________________________________________________________

___________________________________________________________________________________________

Please relate the history of this property, as you know it. ________________________________________________

___________________________________________________________________________________________

___________________________________________________________________________________________

Do you know any information about the original owner of this house or the names of other

families who have lived in this property?_____________________________________________________________

____________________________________________________________________________________________

Do you know anyone else who may enjoy contributing information to the file

for this house and a mailing address where the committee can contact them?__________________________________

____________________________________________________________________________________________

Is there any other information that you would like to share about this house?__________________________________

_____________________________________________________________________________________________

If you need additional space for your answer please add additional pages.

Please give your information to a tavern host or mail to:

Miamisburg Historical Society, Oral History

PO Box 774; Miamisburg, OH 45343