Changes of Address Or Mail Request

Shareholder's Name:
_______________________________________

Shareholder Social Security Number:
_______________________________________

Previous Address:
_______________________________________

_______________________________________

New Address:
_______________________________________

_______________________________________

New Telephone Number:
_______________________________________

 

_______________________________________
Signature

Please fax changes to:
Seldovia Native Association, Inc.
907.234.7637 fax

Or Mail changes to:
Post Office Drawer L
Seldovia, Alaska 99663