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2. 
4. Date*
6. Please change the mailing address for tax parcel #(s)*
8. To:
10. Address*
12. City*
13. State*
14. Zip Code*
16. Phone Number*
18. Email Address
20. 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.
22. Electronic Signature*
24. Is the new mailing address your primary residence?
25. Yes/No*
Leave This Blank:


27. 1. Receive an email copy of this form.
28. Email address

    This field is not part of the form submission.

29. Submit Submit and Print

* indicates a required field