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2. Laurens County E-911 Address Request Form
4. Before you fill out this form please make sure that your future driveway is marked.
   Ribbons, flags etc.
6. Name
7. Email Address
9. Cell Phone Number
10. Other Contact Number
14. Closest Address
    Please describe to us the closest address/addresses to where you are needing a new address assigned.
16. Map Parcel

    Please provide the Map and Parcel Number if available, these can be acquired by visiting the Laurens County Tax Assessors Website.

17. GPS Coordinates

    Please provide GPS coordinates if available.

19. Laurens County Tax Assessors Website

    Visit here to search for Map and Parcel Number

21. Any Additional Details
    Please provide us with any other relevant information related to your new address: things to look for, parcel number etc.
25. For 911 Personnel Only
27. New Address
29. City
30. Zip Code
Leave This Blank:


32. 1. Receive an email copy of this form.
33. Email address

    This field is not part of the form submission.

34. Submit Submit and Print

* indicates a required field