TOWN OF CHINCOTEAGUE, INC. Phone: (757)-336-6519
6150 COMMUNITY DRIVE Fax: (757)-336-1965
CHINCOTEAGUE, VA 23336
NOTICE OF CHANGE OF OWNERSHIP AND/OR ADDRESS
Change of Ownership Change of Address
Location of Property:
Owner’s Name:
Mailing Address:
Phone Number: (____) _____-__________ (H) (____) _____-________(W)
Social Security Number: _________- __________-__________
Driver’s License Number: _________________________ State: ______________
CHECK IF THIS PERSON IS A NEW OWNER! (IF SO COMPLETE THE FOLLOWING)
Previous Owner’s Name:
Forwarding Address:
Date of Settlement: _____/_____/_____
Is this going to be a rental property? Yes No If yes: Yearly Monthly Transient
______________________________________________
Date of Settlement: _______/___/______
FOR TOWN OFFICE USE ONLY (Information Received By: ___________)
This information was received: From_____________________ Date: __________
Water Account Number: ______________
Other Account #’s B.L.___________Meals Tax ________ T.O. Tax _____
Changes Made By: _______ ________ _____
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