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2. 
3. TODAY'S DATE*
   TODAY'S DATE
4. TAX/PAY YEAR*
   (example: 2018 / 2019)
6. St. Joseph County Indiana Mailing Address Change

   ^{(Please note: The Auditor Office uses their discretion when changing mailing addresses. Contact the Assessor's office 574-235-9523 to change PROPERTY address)}

7. I am the property owner or authorized person regarding the following real estate record(s):
   I am requesting the Auditor of St Joseph County change the mailing address of the property listed below:
9. Owner's First Name*
10. Owner's Last Name*
12. Owner's Email *
13. PARCEL ID#*
    (see tax bill)
15. CURRENT MAILING ADDRESS*
16. CITY*
17. STATE/ZIP*
19. NEW MAILING ADDRESS*
20. CITY*
21. STATE/ZIP*

23. ^{Anyone submitting false information on this form is subject to prosecution. See Indiana code 6-1.1-22-8.1, IC 26-2-8-102 for more information.}

24. Electronic Signature Agreement*

    By checking the "I am requesting" box below, you agree and acknowledge that 1) St. Joseph County Auditor may change the mailing address of properties listed above and 2) by electronically signing you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature.

    1. I am requesting
26. OWNER'S SIGNATURE*
27. CONTACT PHONE #*
28. RECEIVED BY:
    internal use only
29. Date:
    Date:

    Date:
Leave This Blank:


31. 1. Receive an email copy of this form.
32. Email address

    This field is not part of the form submission.

33. Submit Submit and Print

* indicates a required field