Date:
Parcel ID:
(Map/Block/Lot)
Property Location:
Owners Name:
Title:
Request of Address Change
The City of Waterbury Assessor’s Office
Change Mailing Address To:
Name (Print):
Signature:
Mailing Address From:
Return Completed & Signed to: Assessor's Office 235 Grand St Waterbury, CT 06702 Fax: 203-574-6992