Change Of Mailing Address Form

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Change of Mailing Address Form
Please complete and return to the PVA Office listed below. Upon receipt of the request we will change the address for
the current year Tax Roll.
Please note, if the current year Tax Roll has been closed, we will not be able to make any changes for the tax roll. We
would suggest that you be sure you have current address changes on file with the US Post Office to ensure you receive
your tax bill(s).
REQUEST FOR MAILING ADDRESS CHANGE
Property Owner: ______________________________________________________________________________
Reason for address request change: _______________________________________________________________
____________________________________________________________________________________________
Please change my mailing address for the following the property located at: (if you have additional properties please list
on back or attach list.)
1. Address: ________________________
2. Address: ___________________________
________________________
___________________________
I understand than until further written notice to the PVA, all mail generated from the Property Tax Roll, including
Assessment Notices and Tax Bills will be mailed to the address below:
Change mailing address to:
Name: _____________________________________________________________________________________
Address: ____________________________________________________________________________________
City: ________________________________________________________ State: _________ ZIP: _____________
I further understand that the PVA Office/Staff assumes no liability for the non-payment of tax bills. I understand that the
property taxes are the responsibility of the property owner.
Request made by:
__________________________________________________________________________________________
Signature:
Printed name:
Date:_________________________________________
Phone: _____________________________________
RETURN THIS FORM TO:
Scott County Property Valuation Administration Office
101 East Main St. Ste 206 (Courthouse)
Georgetown, KY 40324
Phone: 502-863-7885 | Fax: 502-863-7899
SCPVA-Address Change – Rev. 03/29/10

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