Form coa -1
NOTICE OF CHANGE OF ADDRESS
CITY ASSESSORS
PROVIDENCE CITY HALL, PROVIDENCE R.I. 02903
401-421-5900
REAL ESTATE______
MOTOR VEHICLE______
ACCOUNT NO________________________________
PLAT/ LOT#__________________________________
NAME__________________________________________________
NEW ADDRESS________________________________________________
________________________________________________
________________________________________________
TELEPHONE #__________________________
FORMER ADDRESS____________________________________________
____________________________________________
REMOVAL OF LENDER/ MORTGAGEE_______________
NAME OF LENDER / MORTGAGEE________________________________________
DATE_________________________________
TAKEN BY____________________________