TOWNSHIP OF NORTH HANOVER - BURLINGTON COUNTY, NJ DATE OF REQUEST: _____________________ TO: OFFICE OF THE TAX COLLECTOR/ASSESSOR FROM: _______________________________ RE: REQUEST FOR ADDRESS OR NAME CHANGE BLOCK__________ LOT__________PROPERTY LOCATION_____________ DEED DATE___________ BOOK______________PAGE__________________ I hereby request that the mailing address for the above listed Block and Lot be changed TO: _______________________________ _______________________________ _______________________________ ________________________________ I hereby request that the name listed in the Tax Book be corrected to read: ________________________________ ________________________________ Please print Any additional Block and Lots affected by this change are listed below: BLOCK______________ LOT________________ BLOCK______________ LOT________________ _______________________________________ Signature of requestor _______________________________________________________________________________ |