PINELLAS COUNTY PROPERTY APPRAISER
CHANGE OF ADDRESS FORM

PARCEL NUMBER(S):

12-31-16-39726-002-0070

DAYTIME PHONE NUMBER:

EMAIL ADDRESS:

CHANGE MAILING ADDRESS TO:

Address Line 1:
Address Line 2:
City: State: Zip: Country:

REASON FOR ADDRESS CHANGE:

MOVED_________________________Date Moved:

SOLD PROPERTY________________ Date of Sale:

RENTING PROPERTY_____________Date Rented:

TEMPORARILY AWAY____________Expected Return Date:

OWNER DECEASED______________Date of Death:

POWER OF ATTORNEY/GUARDIAN

OTHER REASON FOR CHANGE OF ADDRESS:

Address of primary residence on January 1:

Additional Information:


Notice: Section 196.011(9a), Florida Statute states if any property owner fails to notify the Property Appraiser
and the Property Appraiser determines that for any year within the prior 10 years the owner was not entitled to
receive such exemption, the owner of the property is subject to the taxes exempted as a result of such failure plus
15 percent interest per annum and a penalty of 50 percent of the taxes exempted. It is the duty of the property
appraiser making such determinations to record in the public records of the county a notice of tax lien against
any property owned by that person.

Your address change request should appear in our records within five business days.



Electronic Signature:

By typing my name below as my electronic signature, I hereby state that the information I have provided on this form is true and correct.

Relationship (Select all that apply. Hold the "Ctrl" key while clicking with the mouse to select more than one item):

Pinellas County Property Appraiser
PO Box 1957
Clearwater, FL 33757-1957
FAX: 727-464-3448