NOTE: We no longer have a fax number. Click on the contact link for our phone number and email address.

Online Change of Trade Form



Fill out this form to change your company name or address. Note that you only need to fill out parts that have changed. If you currently have a company name and want to remove your license from that company, type "Remove" in the field for New Company Name.

Your Name: Your License Number:
Previous Company Name:
New Company Name:
New Mailing Address:
Street:
City, State, Zip:
New Physical Address:
Street:
City, State, Zip:
New Business Phone Number: New Cell Phone Number:
New Email: