City of Troy NY
c/o City Assessor
433 River Street
Troy, NY 12180
REQUEST FOR CHANGE OF MAILING ADDRESS FORM
Date: ___________________________________
Owner(s) of Property: ___________________________________
___________________________________
Owner Telephone #: ___________________________________
Property Location(s):
__________________________________ SBL# ______________________
__________________________________
SBL# ______________________
__________________________________
SBL# ______________________
__________________________________
SBL# ______________________
I hereby request as owner(s) of the above stated properties that any correspondence be sent to
the following mailing address:
____________________________________
____________________________________
____________________________________
Water & Recycle Bills are also to be effected? Yes / No
It is acknowledged that the owner(s) physical primary residence is the following:
_____________________________________
_____________________________________
_____________________________________
Owner(s) Signature: _______________________Title_______________ Dated: _________________
Owner(s) Signature: _______________________Title_______________ Dated: _________________
Office of the Assessor
Phone (518) 279-7127
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