Change of Address or Name Form

Assessment Number*

Property Address*

Contact Email*

Existing Information

Title

Given Names*

Surname or Business Name*

Phone - Home*

Work

Fax

Mobile*

Existing Property Address

Existing Mailing Address*

New Information

Title

Given Names*

Surname or Business Name*

Phone - Home*

Work

Fax

Mobile*

New Property Address

New Mailing Address

Is this NEW address the Preferred Mailing Address for ALL correspondence from the City of Vincent*

YesNo

If NO, then please indicate which department will be affected by the above change of details:

Rates Dept
Planning Dept
Creditor/Debtor
Building Dept
Dog Registrations
Health Dept
Waste Management

Other

Comments

Please upload any documentation supporting this application i.e. Certificate of Title, Death Certificate, Power of Attorney or Probated Will listing the executor as required:

Max File Size: 10.00 MB
Allowed File Types: .avi, .doc, .docx, .gif, .jpeg, .jpg, .mov, .mp3, .mp4, .mpeg, .mpg, .pdf, .png, .ppt, .pptx, .xls, .xlsx

I agree that the information is true and correct and that I am authorised to request these changes*

I Agree

Change of Address or Name Form

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