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Address Change Request Form-Electronic
Date:
Accounts: (Required)
Owner Name: (Required)
Home Phone (Required):
Email Address: (Required)
Business Phone:
Cell Phone:
Other Phone:
Old Address: (Required)
New Address: (Required)
By submitting this form and clicking "I Agree" I understand that I am are providing my digital signature and that I am authorized to do so. "Digital signature" means an electronic identifier intended by the person using it to have the same force and effect as the use of a manual signature. The use of a digital signature under this section is subject to criminal laws pertaining to fraud and computer crimes, including Chapters 32 and 33, of the Texas Penal Code.
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Contact Information
903-763-4891
903-763-4183
P.O. Box 1706
Quitman, TX 75783-1706
210 Clark St.
Quitman, TX 75783-2442
Monday - Friday 8:00 a.m. - 4:30 p.m.
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