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2. Margaret S. Torrence
   Commissioner of Revenue
   1255 Franklin St., Suite 102
   Rocky Mount, VA 24151
   State Taxes and Personal Property Phone: 540-483-3083
   Real Estate Phone: 540-483-3085
   Land Use Phone: 540-483-3084
   Fax: 540-483-3089
4. Account Name or Business Name*
6. Which records do you wish to change?*

   1. Personal Property Record
   2. Real Estate Record
   3. Both Personal Property & Real Estate Record
7. Which type of change do you need us to make?*

   1. Name
   2. Address
   3. Both Name and Address
9. Former Name*
10. When did you move?*
12. Did you change your address with the Department of Motor Vehicles

    1. Yes
    2. No
    3. Not Applicable
14. Did you change your address with the Department of Game and Inland Fisheries?

    1. Yes
    2. No
    3. Not Applicable
16. Old Address
18. City
19. State
20. Zip Code
22. New Address*
24. City*
25. State*
26. Zip Code*
28. Is Physical Address same as New Address?*

    1. Yes
    2. No
    3. Not Applicable
29. New Physical Address
31. CONTACT INFORMATION
33. Phone*
34. Email Address
36. Electronic Signature Agreement

    By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.

    1. I agree.
38. Electronic Signature
39. Date
    Date
41. IMPORTANT MESSAGE: The Commission of Revenue office will contact you to obtain additional information needed to process this request.
Leave This Blank:


43. 1. Receive an email copy of this form.
44. Email address

    This field is not part of the form submission.

45. Submit

* indicates a required field