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2. 
4. REQUEST FOR MAILING ADDRESS CHANGE
6. Name of Requesting Party:
8. First Name
9. Last Name
11. Phone Number
12. E-mail Address
14. Parcel Number
15. Property Address
17. Parcel Number
18. Property Address
20. Parcel Number
21. Property Address
25. REQUESTED MAILING ADDRESS
27. Care of (optional)
29. Address
31. City
32. State
33. Zip Code
35. I hereby request that the mailing address of the parcel(s) noted above be changed; I certify that I am the property owner or I have been authorized by the property owner to request the changes(s). Also, I understand that any mailing address change will apply to property tax billing only, If I wish to change a mailing address for utility billing or voter registration purposes. I will make a request for this change at the appropriate department (Finance Department for utility billing & City Clerk's Office for voter registration). Disclaimer: Information submitted on this form will be sent via email. To protect sensitive information, do not request the following information on this form: Social Security numbers, driver’s license numbers, bank account information, routing numbers, medical information, passport numbers, and passwords.
37. Automatically update Utilities with Treasury?

    1. Treasury@Portagemi.gov
39. Electronic Signature Agreement

    By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.

    1. I agree.
41. Electronic Signature
42. Date
Leave This Blank:


44. 1. Receive an email copy of this form.
45. Email address

    This field is not part of the form submission.

46. Submit

* indicates a required field