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2. Date*
   Date
4. Rental*

   1. Yes

   1. No
6. Name*
7. Only Owner*

   1. Yes

   1. No
9. If More than One Owner
   List names of ALL other owners.
11. Phone Number*
12. Email Address*
14. Property Address*
15. Parcel Number*
    Your Parcel Number may be found on your Tax Bill, Assessment Notice, by calling the Assessing Office, and through our Property Search function.
17. New Mailing Address*
19. Comments
21. Electronic Signature Agreement*

    By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.

    1. I agree.
23. Electronic Signature*
25. NOTE:
    If the homeowner’s mailing address has changed, it may be necessary to complete the Request to Rescind Homeowner’s Principal Residence Exemption (PRE) form 2602 if the homeowner is no longer living at the property address. It is not necessary to rescind the PRE if the homeowner is in assisted living and planning to return home or in a nursing home. However, please inform the staff in the Assessing Office to ensure the exemption does not get removed.
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27. 1. Receive an email copy of this form.
28. Email address

    This field is not part of the form submission.

29. Submit Submit and Print

* indicates a required field