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CORTLAND Real Property Tax Services COUNTY P: [PHONE REDACTED] NEW YORK Laura Fox – Director CHANGES TO ADDRESS AND/OR NAME Make sure to sign and date form at the bottom and return to assessor. Town of: Tax map no.(s): Section 1 – Address Changes Name & Old Address New Address: If request is to send the bill “in care of” another individual, please state complete name and address. Section 2 – Name Changes Name Currently Listed: Name Changed To: Reason For Change: Marriage Marriage Certificate enclosed Divorce Divorce Decree enclosed A marriage certificate or divorce decree must be enclosed in order to make the change. This change will affect the assessment roll only. Steps must be taken to change legal title to the property. Section 3 - Name removal due to death of owner Names Currently Listed: Name to be Removed: Death Certificate enclosed A death certificate must be enclosed in order to make the change. This change will affect the assessment roll only. Steps must be taken to change legal title to the property. Signature Date