2. 

4. Barbara D. Phillips
   Tax Assessor

6. CITY OF PASSAIC
   OFFICE OF TAX ASSESSOR
   330 PASSAIC STREET

   PASSAIC, NJ 07055
   PHONE (973) 365-5541

   ADDRESS CHANGE FORM
   
   
   

8. DATE:*
   DATE:

    

10. Property Location*
12. Block:*
13. Lot#:*
14. Qualifier:*
16. Owner's Name:*
18. Change From:
20. Address (old):*
22. Phone Number:*
24. Change to:
26. Address (new):*
28. Owner Signature:*
29. SUBMIT A COPY OF YOUR PHOTO ID:*
31. FOR OFFICIAL USE
33. Received By:
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35. 1. Receive an email copy of this form.
36. Email address

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