Tax Commissioner

Change of Address Request

Applicant Name: * This field is required

Driver's License: *
(if no Driver’s License then Georgia issued photo ID)

This field is required

Site Address of Property: * This field is required

Map/Parcel Number(s): * This field is required

Old Mailing Address:

Street Address: * This field is required

City:* This field is required

State:* State Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Washington DC Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennslyvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming This field is required

Zip:* This field is required

New Mailing Address: *

Street Address: This field is required

City: * This field is required

State: * State Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Washington DC Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennslyvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming This field is required

Zip: * This field is required

Reason for Change: * This field is required

Homestead on property? *

Yes No

---

By signing below, I am certifying the information above true and correct. I am also validating that I am the authorized agent or taxpayer responsible for receiving and or paying these taxes.

The following fields constitute an Electronic Signature.

Taxpayer/Authorized Agent Name: * This field is required

Company Name (if applicable):

Phone #: * This field is required

Email: * This field is required

Date: * This field is required