No Longer Own This Property Request · DCA Service Portal (TEST)

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PROPERTY INTEREST SUMMARY

Property Interest

Property Type

County

Municipality

Issue NTR?

NoYes

Requester

Authorized Agent Same As Primary Property Owner?

NoYes

Estimated Date of Ownership Transfer [mm/dd/yyyy]

*

NEW OWNER'S INFORMATION

Organization/Agency Name

*

First Name

*

Last Name

*

Address Line 1

*

City

*

State/Providence

*

Zip/Postal Code

*

REQUESTER COMMENTS

*

Notes & Attachments

Attachments