New Address Request Form
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1Dutchess County Real Property Tax Service Agency
New Address Request Form
Office Phone; (845) 486-2140
Fax Number: (845) 486-2093
22 Market St, Poughkeepsie, New York 12601
rptaddressing@co.dutchess.ny.us
Name of Firm or Person requesting address information ____________________________________
Contact person _______________________________________
Date: ___________________
Phone #: __________________________________
Fax #: ___________________________
TO BE FILLED IN BY PERSON REQUESTING NEW ADDRESS:
1.
Type of Request:
(
)
Resale
(
)
New Construction
(
)
Sub-division
(
)
Other _____________________
2.
Real Property Tax Parcel Grid Number:
13
_____________-_____________-__________-_____________-________
Swis code (4)
Section (4)
Block (2)
Lot (6)
Suffix (4)
Filed Map Number (if available): ________________ Lot #_________
3.
Parcel old address (if applicable):
_______________________________________________________________________
4.
Former owner of parcel or structure:
_______________________________________________________________________
5.
New owner of parcel or structure:
_______________________________________________________________________
Attach a plot plan showing actual location of driveway:
6.
========================================================================
To be completed by RPT Addressing Staff:
New assigned 9-1-1 address: _______________________________________________
Name of Technician: ___________________________ Date Assigned: _____________
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