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Change of Name or Address Form

If submitting form by post, fax or email, please print and return to:

Municipality of Northern Bruce Peninsula
56 Lindsay Road 5
Lion’s Head, ON N0H 1W0
Fax: 519-793-3823
Email to: taxclerk@northernbruce.ca

Roll Number:

I have another property Remove this property

Name:

Former name:

Proof of name change (Marriage Licence, etc.):

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Allowed extensions pdf, doc, docx, xls, xlsx, jpg, jpeg, gif, png, tif

Mailing address:

Phone number:

Signature of Property Owner:

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Personal information on this form is collected under the authority of the Municipal Act, 2001, and will be used for the purpose of updating contacting information. Questions regarding the collection of this information should be directed to the Clerk at 1-833-793-3537 ext. 236.