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Request for Change of Address

Request for Change of Address

Fields marked with a red star (*) are mandatory.

Request for Change of Address


Complete this form when an address correction is required for property owners, registered vendors, marked fuel permits, revenue tax exemption permits and/or GeoLinc Plus users.
Name of Applicant: *
GST or federal business number (BN):
(if applicable)


Indicate reason and effective date for address change


Reason: *
Effective Month: *
(mm)
Effective Day: *
(dd)
Effective Year: *
(yyyy)


Please fill out all applicable information to which the address change will apply


Property Number:
Location:
Property Number:
Location:
Property Number:
Location:
Property Number:
Location:


Vendor Registration Information


Vendor Number:
Environment Tax Number:
Legal Business Name:


Marked Gasoline/Diesel Oil Permit Information


Marked Gasoline/Diesel Oil Permit Number:


Revenue Tax Exemption Permit Informaton


Revenue Tax Exemption Permit Number:


GeoLinc Plus Information


Username:
Email:


Previous Address


Mailing Address: *
City, Town, Village: *
Province/State: *
Postal Code/Zip: *


New Address


Mailing Address: *
City, Town, Village: *
Province/State: *
Postal Code/Zip: *


Requested By


Name: *
Mailing Address: *
City, Town, Village: *
Province/State: *
Postal Code/Zip: *
Telephone: *
Email:


Authorization


I authorize the changes to the address as outline in this request.
Freedom of Information and Protection of Privacy


Personal information on this form is collected under the authority of Section 31(c) of the Freedom of Information and Protection of Privacy Act and will be used for the purposes of tax administration and enforcement. Questions on the collection and use of this information can be directed to the Manager, Corporate and Tax Administration Services, PO Box 2000, Charlottetown, PE C1A 7N8 (902) 368-5137.

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Please send me a simple text-only version of the information I submitted.
Please send me an Acrobat version of the form, with the information I've entered above filled in, that I can print and save.
Please send me both the text-only version and the PDF.
Important Note: Email is not, by its very nature, a secure medium; if you choose to have your form emailed to you, the information you entered will be transmitted over the public Internet to your email box.

Email to address:

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When you click here, the information you've entered above will be sent to the public servant responsible for receiving and processing this form. If you've opted to receive an Acrobat version of the form by email, you will receive this file shortly.
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