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REVENUE AND TAXATION GOVERNMENT OF GUAM Gubetnamenton Guhan (Guam Department of Revenue & Taxation)

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Dipåttamenton Kontribusion yan
Adu’ånå
EDDIE BAZA CALVO, Governor Maga’låhi
RAYMOND TENORIO, Lt. Governor Tiñente Gubetnadora
DEPARTMENT OF
REVENUE AND TAXATION
GOVERNMENT OF GUAM Gubetnamenton Guåhan
JOHN P. CAMACHO, Director
Direktot
MARIE M. BENITO
Deputy Director
Segundo Direktot
Post Office Box 23607, Guam Main Facility, Guam 96921 Tel. / Telifon: (671) 635-1896/1763 Fax / Faks: (671) 633-2643
REAL PROPERTY TAX DIVISION
REQUEST FOR OWNER IDENTIFICATION NUMBER
Section 24109, Article 1, Chapter 24, Title 11, Guam Coded Annotated, requires each owner of real property to provide
his taxpayer identification number (SSN or EIN) to the Department of Revenue and Taxation (DRT), Real Property Tax
Division. If any person fails to comply with such requirement, such person shall, unless it is shown that such failure is
due to reasonable cause and not to willful neglect, pay a penalty of One Hundred Dollars ($100.00) for each failure. The
Department (DRT) may make use of the taxpayer identification number for internal purposes only, to include, but not
limited to, the assessment and collection of taxes.
OWNER(S) NAME: TIN (SSN or EIN):
__________________________________________ _________________________
__________________________________________ _________________________
__________________________________________ _________________________
E-MAIL ADDRESS: _____________________________________________________________
MAILING ADDRESS: _____________________________________________
_____________________________________________
_____________________________________________
PHONE: ____________________________
(List all properties currently owned – attach additional sheet(s) if necessary)
PIN: ________________________ PARCEL DESCRIPTION ____________________________________
PIN: ________________________ PARCEL DESCRIPTION ____________________________________
PIN: ________________________ PARCEL DESCRIPTION ____________________________________
Signature ______________________________ Date________________
Signature ______________________________ Date________________
Signature _______________________________ Date________________
FOR OFFICE USE
_____________________________________________________ _________________________
Processed by Date
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REVENUE AND TAXATION GOVERNMENT OF GUAM Gubetnamenton Guhan (Guam Department of Revenue & Taxation)

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Completed 22 June 2021

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