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SECRETARY OF STATE PROFESSIONAL LICENSING BOARDS DIVISION 237 Coliseum Drive Macon, Georgia 31217 Phone (404) 4249966NAME & ADDRESS CHANGE REQUEST FORM Licensed individuals must submit this form to

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What is name & address change?

Name & address change is the process of updating personal information such as name and address.

Who is required to file name & address change?

Anyone who has had a change in their name or address is required to file a name & address change.

How to fill out name & address change?

To fill out a name & address change, one must follow the specific instructions provided by the relevant authority or organization.

What is the purpose of name & address change?

The purpose of name & address change is to ensure that personal records are accurate and up to date.

What information must be reported on name & address change?

The information that must be reported on a name & address change typically includes the old and new name or address.

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