Address Application
Property Owner*
Applicant Name (if different from owner)*
Current Address*
Call back number*
Alternate phone number
Structure type*
Road Name
Closest address to new site
Is your driveway clearly marked ? This must be done before an address can be assigned.
 no
 yes
Will you share a driveway with another address
 no
 yes
Location of your new site in relationship to address(es) on the shared drive
Additional information or instructions
Please include your email address if you would like to have your new address emailed to you
Please include your fax number (including area code) if you would like to have your address faxed to you
If you have not chosen to have your new address faxed or emailed, it will be available for you to pick up in person at the Voter's Registration Office located at 320 E. Main St. usually within three business days of application. If you have questions please call 864-426-1498.


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