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Town of Natick Important Legal Document: Annual Street Listing

  1. Town of Natick
    Board of Registrars
    13 E. Central St.
    Natick, MA 01760

  2. Important:

    General Laws of Massachusetts mandate an annual street listing of residents as of January 1 each year. Update the information provided by adding, deleting, or making changes. Please sign and respond within 10 days, even if no changes are necessary. For assistance, call the Town Clerk, at 506-647-6430, extension 4.

  3. Instructions

    • Verify and/or complete all information listed on the form.
    • List all family or household members whose legal address is the same. Include any member of the family in military service, away at school, or confined to a rest home whose legal residence is the same.
    • Make all changes on the shaded line below the printed line.
    • If a new member has been added to the family or household, enter the name and information on the blank line at the end of this form.
    • Put a line through the name of any resident no longer residing at this address and list his/her new address.
    • Moved / Deceased - Check "Moved" or "Deceased" if appropriate.
    • Occupation - Enter occupation - not place of employment.
    • Nationality - Enter only if not a U.S. citizen.
    • Veteran - Check if you are a U.S. veteran.

  4. Warning:

    Failure to respond to this form shall result in removal from the active voting list and may result in removal from the voter registration rolls.

  5. #1

  6. Voter

    Checking indicated a registered voter. You cannot register to vote with this form.

  7. Mail To

  8. Gender*

  9. Moved / Deceased

    If no longer at the residence, please indicate why.

  10. If not a U.S. citizen

  11. Veteran Status

  12. Previous Address if at Current Address for Less Than 1 Year

  13. #2

  14. Voter

    Checking indicated a registered voter. You cannot register to vote with this form.

  15. Mail To

  16. Gender*

  17. Moved / Deceased

    If no longer at the residence, please indicate why.

  18. If not a U.S. citizen

  19. Veteran Status

  20. Previous Address if at Current Address for Less Than 1 Year

  21. #3

  22. Voter

    Checking indicated a registered voter. You cannot register to vote with this form.

  23. Mail To

  24. Gender*

  25. Moved / Deceased

    If no longer at the residence, please indicate why.

  26. If not a U.S. citizen

  27. Veteran Status

  28. Previous Address if at Current Address for Less Than 1 Year

  29. #4

  30. Voter

    Checking indicated a registered voter. You cannot register to vote with this form.

  31. Mail To

  32. Gender*

  33. Moved / Deceased

    If no longer at the residence, please indicate why.

  34. If not a U.S. citizen

  35. Veteran Status

  36. Previous Address if at Current Address for Less Than 1 Year

  37. #5

  38. Voter

    Checking indicated a registered voter. You cannot register to vote with this form.

  39. Mail To

  40. Gender*

  41. Moved / Deceased

    If no longer at the residence, please indicate why.

  42. If not a U.S. citizen

  43. Veteran Status

  44. Previous Address if at Current Address for Less Than 1 Year

  45. #6

  46. Voter

    Checking indicated a registered voter. You cannot register to vote with this form.

  47. Mail To

  48. Gender*

  49. Moved / Deceased

    If no longer at the residence, please indicate why.

  50. If not a U.S. citizen

  51. Veteran Status

  52. Previous Address if at Current Address for Less Than 1 Year

  53. #7

  54. Voter

    Checking indicated a registered voter. You cannot register to vote with this form.

  55. Mail To

  56. Gender*

  57. Moved / Deceased

    If no longer at the residence, please indicate why.

  58. If not a U.S. citizen

  59. Veteran Status

  60. Previous Address if at Current Address for Less Than 1 Year

  61. #8

  62. Voter

    Checking indicated a registered voter. You cannot register to vote with this form.

  63. Mail To

  64. Gender*

  65. Moved / Deceased

    If no longer at the residence, please indicate why.

  66. If not a U.S. citizen

  67. Veteran Status

  68. Previous Address if at Current Address for Less Than 1 Year

  69. #9

  70. Voter

    Checking indicated a registered voter. You cannot register to vote with this form.

  71. Mail To

  72. Gender*

  73. Moved / Deceased

    If no longer at the residence, please indicate why.

  74. If not a U.S. citizen

  75. Veteran Status

  76. Previous Address if at Current Address for Less Than 1 Year

  77. #10

  78. Voter

    Checking indicated a registered voter. You cannot register to vote with this form.

  79. Mail To

  80. Gender*

  81. Moved / Deceased

    If no longer at the residence, please indicate why.

  82. If not a U.S. citizen

  83. Veteran Status

  84. Previous Address if at Current Address for Less Than 1 Year

  85. #11

  86. Voter

    Checking indicated a registered voter. You cannot register to vote with this form.

  87. Mail To

  88. Gender*

  89. Moved / Deceased

    If no longer at the residence, please indicate why.

  90. If not a U.S. citizen

  91. Veteran Status

  92. Previous Address if at Current Address for Less Than 1 Year

  93. #12

  94. Voter

    Checking indicated a registered voter. You cannot register to vote with this form.

  95. Mail To

  96. Gender*

  97. Moved / Deceased

    If no longer at the residence, please indicate why.

  98. If not a U.S. citizen

  99. Veteran Status

  100. Previous Address if at Current Address for Less Than 1 Year

  101. Dog licenses are due by March 1, 2014.

  102. Digitally signed under penalties of perjury as prescribed by M.G.L. 56, §4.

  103. Leave This Blank: