Please complete this form if you need to update your address with the
Mesa City Prosecutor’s Office.
Date of Birth
Last 4 digits of SSN
Primary Phone Type (cell, home, work, etc.)
Secondary Phone Type (cell, home, work, etc.)
To change your personal
contact information with the Mesa Municipal Court, you must appear in
person with identification.
I understand that this form
is intended solely for the use of crime victims to submit information
to the Prosecutor’s Office, and that any person not authorized to
provide information for the crime victim or anyone who knowingly submits
information that is untruthful or false, may be subject to prosecution.
I confirm that I am the person named above or have permission from the
person named above to submit information on their behalf.
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