Appendix A: FTP Account Request Form

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Account-based FTP Account Request Form

 Customer Name*  
 Customer Address*  
 Customer Address Line 2  
 ZIP Code*  
 Business Phone Number*  
 Business FAX Number  
 Contact Name*  
 Contact Title*  
 Contact Phone Number*  
 Contact E-mail Address*  

Fax or submit completed request form to:

Columbia County Tax Commissioner
Attention: Peter Chong
P.O. Box 3030
Evans, GA 30809

Telephone: (706) 261-8299
Facsimile: (706) 312-1357
E-Mail: Peter Chong