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2. Date*
4. First Name*
5. Last Name*
7. *If not the taxpayer of record, a deed, land contract, divorce judgement or letter of authorization must be attached.
9. Address of Subject Property*
11. Parcel I.D. Number
13. Is this a temporary or permanent change?*
15. Is the property your principle residence?*
17. Is the property rented / leased?*
19. Is the change requested a result of a recent sale / transfer of ownership?*
    *IF YES, A COPY OF THE COMPLETED PROPERTY TRANSFER AFFADAVIT MUST BE ATTACHED FOR THIS REQEUST TO BE PROCESSED.
21. Reason for Change*
23. Name Change From
25. Name Change To
27. Current Mailing Address
29. New Mailing Address
31. Phone Number*
32. Cell Phone Number
34. Property Owners Signature*
36. PLEASE COMPLETE THE FORM ENTIRELY AND RETURN TO CITY OF DAVISON, CITY HALL.
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38. 1. Receive an email copy of this form.
39. Email address

    This field is not part of the form submission.

40. Submit Submit and Print

* indicates a required field