This form is used for permanent address changes only. It is not intended for temporary or seasonal change in residence. Note: Tax bills may have been printed prior to this request. It is the property owner's responsibility to call the town or city tax collector for bill amounts. Property Record Town or City Town of City of Municipality - Select -BARKERBINGHAMTONCHENANGOCOLESVILLECONKLINDICKINSONFENTONKIRKWOODLISLEMAINENANTICOKESANFORDTRIANGLEUNIONVESTALWINDSOR Tax Map Number Property Address Owner(s) of Record Owner of Record's Listed Full Name Owner of Record's Listed Full Name Owner of Record's Listed Full Name Item weight Add more items more items Phone Number Email Address Change(s) Requested Note: To remove a name from tax bills a new deed must be filed in the Broome County Clerk's Office. Change Type Address only Name only Address and Name Address Change Correct Mailing Address Address Address 2 City/Town State/Province - Select -AlabamaAlaskaAmerican SamoaArizonaArkansasArmed Forces (Canada, Europe, Africa, or Middle EastArmed Forces AmericasArmed Forces PacificCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFederate States of MicronesiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarshall IslandsMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPalauPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirgin IslandsVirginiaWashingtonWest VirginiaWisconsinWyoming ZIP/Postal Code Name Change Previous Full Name Changed Full Name Reason for Name Change - Select -DivorceMarriageLegal Court Processed Name Change Proof of Name Change Attach a legal document with proof of the name change such as a Divorce Decree, Marriage Certificate, Court Order, or Power of Attorney Letter. One file only.500 MB limit.Allowed types: txt rtf pdf doc docx odt ppt pptx odp xls xlsx ods. Signature DECLARATION: I declare, subject to the penalties of perjury, that the statements made on this form, including statements made in any accompanying papers, are true. I understand that all statements made by me in connection with this form are subject to investigation and verification and that a material misstatement or fraud may result in criminal penalties. Acknowledgement Property Owner Signature By checking the Acknowledgement box and typing my name in the signature field I am agreeing to the above declaration and verifying all information is accurate. Date What code is in the image? Enter the characters shown in the image.