ADDRESS CHANGE AUTHORIZATION
COUNTY OF LAKE
OFFICE OF THE ASSESSOR
Phone: 707 / 263-2302
Fax: 707 / 263-3703
Mail or Return to:
RICHARD A. FORD
LAKE COUNTY ASSESSOR
255 North Forbes Street, RM 223
Lakeport, CA 95453-4700
The following will be my mailing address for Property Tax Billing and Assessment purposes for
my property in Lake County.
Parcel Number(s) – list all numbers:
APN
:
APN:
APN: APN:
Do you have a boat or aircraft assessed in Lake County? Yes ____ No ____
Do you have a business assessed in Lake County? Yes ____ No ____
If yes, name of business:
NAME (please print):
ADDRESS (please print):
City: State: Zip:
Daytime Phone:
Date: Signature: Eff. Date: