Contact Information:

Date        
       

Information Needed For Your New Address:

 


What side of the road is the dwelling on?
North

Can the building be seen from the road? *

What type of structure is this? *



The structure is *

Will the structure share a driveway with another structure? *


If you are standing in front of your new building looking toward the road:

The nearest 9-1-1 address to your right is:

The nearest 9-1-1 address across the road is:

Comments or other helpful information:

Requirements and Other Information
1. The driveway must be clearly marked before your address request will be processed.
2. If you don't know the PIN number for the property, you can obtain it from The Supervisor of Assessments office at the Marion County Courthouse. You can reach their office by calling 618-548-3853.
3. Please complete this form completely and verify that all the information you have provided is correct to the best of your knowledge.
4. Please allow up to ten (10) working days to complete the request.
5. After all requirements have been met and the address request form has been processed, a confirmation letter will be sent to the address you provided under your current information.
6. If you have any questions please call, email, or visit our office.

Attention: Before submitting this form make sure your driveway has stakes tied with white tape and your last name written somewhere on it. This is to ensure our coordinators can find the driveways. Thank you.