CARMEN CHU ASSESSOR-RECORDER SAN FRANCISCO OFFICE OF THE ASSESSOR-RECORDER CHANGE OF MAILING ADDRESS REQUEST Please use this form to report a change in mailing address. It must be signed by an owner, their attorney, an officer of the corporation, or an authorized property manager. It is the owner's responsibility to advise the Assessor when the mailing address has changed. If you have any questions regarding your mailing address, please call (415) 554-4877. Please type or print clearly, sign, and mail completed form to: San Francisco Assessor-Recorder's Office Attn: Change of Address Unit City Hall, Room 190 1 Dr. Carlton B. Goodlett Place San Francisco, CA 94102 1. Assessor's Parcel No. (from annual tax bill): VOLUME 2. Property Address Location: BLOCK LOT _________________________________________________________ Number and Street City State Zip Code 3. Old Mailing Address: 4. New Mailing Address: _________________________________________________________ Number and Street City State Zip Code _________________________________________________________ Number and Street City State Zip Code 5. Care of Name (if applicable): _________________________________________________________ _______________________ Month / Day / Year Certification 6. Effective Date of Address Change: I certify (or declare) under penalty of perjury under the laws of the State of California that the foregoing and all the information hereon, including any accompanying statements or documents, is true, correct, and complete to the best of my knowledge and belief. ___________________________________________________________________________________ Signature of Person Requesting Change Title Assessor's Use Only Print Name of Person Requesting Change Add___________ Change __________ Delete _________ Approved by: ____________________________________ Print Name Print Name Date Date Rev. 3/4/13 Date ( ) Daytime Telephone Number (Required) Processed by: ___________________________________ E-mail City Hall Office: 1 Dr. Carlton B. Goodlett Place Room 190, San Francisco, CA 94102-4698 Tel: (415) 554-5596 Fax: (415) 554-7151 www.sfassessor.org email: assessor@sfgov.org American LegalNet, Inc. www.FormsWorkFlow.com