Address Change Request
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Address Change Request Form. This is a Maryland form and can be use in District Court Statewide.
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Tags: Address Change Request, DC-65, Maryland Statewide, District Court
DISTRICT COURT OF MARYLAND FOR
City/County
Located at
Case No.
Court Address
STATE OF MARYLAND
OR
vs.
Plaintiff
Defendant
ADDRESS CHANGE REQUEST
Name:
Criminal
Traffic
Trial/Hearing Date:
Civil
Please update the record in this case to reflect my correct/new mailing address.
I am the:
Defendant
Witness
Complainant
Plaintiff
Petitioner
Respondent
Other (Specify):
My OLD address was:
Address
Suite/Apartment #
City
State
Zip
My NEW address is:
(if P.O. Box is given, must also provide street address)
Address
Suite/Apartment #
City
State
Zip
Signature
Date
Print Name
Telephone
DC 65 (12/2009)
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