2. DATE
   DATE
4. BLOCK*
5. LOT*
6. QUALIFIER
8. PROPERTY LOCATION*
10. OWNER*
12. NEW MAILING STREET ADDRESS*
14. NEW MAILING CITY*
15. STATE*
16. ZIP CODE*
18. PHONE NUMBER*
19. FAX NUMBER
21. EMAIL ADDRESS*
23. SIGNATURE*
    BY PRINTING NAME AND SUBMITTING FORM, YOU ARE TRUTHFULLY STATING THAT YOU ARE THE ABOVE-MENTIONED PROPERTY OWNER. YOU ARE ALSO AWARE THAT THIS WILL CHANGE YOUR MAILING ADDRESS FOR TAX AND WATER/SEWER BILLS ONLY.
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25. 1. Receive an email copy of this form.
26. Email address

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27. Submit

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