Form preview

Get the free Change of Name and Address Request Form

Get Form
This document serves as an application for individuals licensed by the State Board of Examiners in Speech-Language Pathology and Audiology in Pennsylvania to request a change of their name and/or address. It outlines the necessary information to be provided, the fees involved, and the acceptable verification documents required for processing the requests.
We are not affiliated with any brand or entity on this form

Get, Create, Make and Sign change of name and

Edit
Edit your change of name and form online
Type text, complete fillable fields, insert images, highlight or blackout data for discretion, add comments, and more.
Add
Add your legally-binding signature
Draw or type your signature, upload a signature image, or capture it with your digital camera.
Share
Share your form instantly
Email, fax, or share your change of name and form via URL. You can also download, print, or export forms to your preferred cloud storage service.

Editing change of name and online

9.5
Ease of Setup
pdfFiller User Ratings on G2
9.0
Ease of Use
pdfFiller User Ratings on G2
In order to make advantage of the professional PDF editor, follow these steps below:
1
Log in to your account. Start Free Trial and sign up a profile if you don't have one yet.
2
Prepare a file. Use the Add New button to start a new project. Then, using your device, upload your file to the system by importing it from internal mail, the cloud, or adding its URL.
3
Edit change of name and. Rearrange and rotate pages, add new and changed texts, add new objects, and use other useful tools. When you're done, click Done. You can use the Documents tab to merge, split, lock, or unlock your files.
4
Save your file. Select it in the list of your records. Then, move the cursor to the right toolbar and choose one of the available exporting methods: save it in multiple formats, download it as a PDF, send it by email, or store it in the cloud.
With pdfFiller, it's always easy to work with documents. Check it out!

Uncompromising security for your PDF editing and eSignature needs

Your private information is safe with pdfFiller. We employ end-to-end encryption, secure cloud storage, and advanced access control to protect your documents and maintain regulatory compliance.
GDPR
AICPA SOC 2
PCI
HIPAA
CCPA
FDA

How to fill out change of name and

Illustration

How to fill out change of name and

01
Obtain the change of name application form from your local government office or their website.
02
Fill out your current name and the name you wish to change to in the appropriate sections.
03
Provide your personal information, including your date of birth, address, and any identification numbers required.
04
Include the reasons for your name change if prompted (this may vary by jurisdiction).
05
Gather any necessary supporting documents, such as identification or proof of residence.
06
Sign and date the application form.
07
Submit the completed application form along with any required fees to the appropriate government office.
08
Wait for your application to be processed and follow any additional instructions provided.

Who needs change of name and?

01
Individuals who have undergone a significant life change, such as marriage or divorce.
02
Persons who wish to change their name for personal or cultural reasons.
03
Individuals seeking to adopt a new name to reflect their gender identity.
04
People who want to distance themselves from a past identity for personal safety or privacy.
Fill form : Try Risk Free
Users Most Likely To Recommend - Summer 2025
Grid Leader in Small-Business - Summer 2025
High Performer - Summer 2025
Regional Leader - Summer 2025
Easiest To Do Business With - Summer 2025
Best Meets Requirements- Summer 2025
Rate the form
4.8
Satisfied
59 Votes

For pdfFiller’s FAQs

Below is a list of the most common customer questions. If you can’t find an answer to your question, please don’t hesitate to reach out to us.

People who need to keep track of documents and fill out forms quickly can connect PDF Filler to their Google Docs account. This means that they can make, edit, and sign documents right from their Google Drive. Make your change of name and into a fillable form that you can manage and sign from any internet-connected device with this add-on.
To distribute your change of name and, simply send it to others and receive the eSigned document back instantly. Post or email a PDF that you've notarized online. Doing so requires never leaving your account.
The premium subscription for pdfFiller provides you with access to an extensive library of fillable forms (over 25M fillable templates) that you can download, fill out, print, and sign. You won’t have any trouble finding state-specific change of name and and other forms in the library. Find the template you need and customize it using advanced editing functionalities.
A change of name is a legal process through which an individual or entity can officially change their name.
Individuals who wish to legally change their name, or organizations that need to update their registered name, are required to file a change of name.
To fill out a change of name application, one must complete the required forms, provide identification, and submit them to the appropriate government authority.
The purpose of a change of name is to officially recognize a new name for personal, familial, or professional reasons.
The information that must be reported typically includes the individual's current name, the desired new name, and sometimes the reason for the change.
Fill out your change of name and online with pdfFiller!

pdfFiller is an end-to-end solution for managing, creating, and editing documents and forms in the cloud. Save time and hassle by preparing your tax forms online.

Get started now
Form preview
If you believe that this page should be taken down, please follow our DMCA take down process here .
This form may include fields for payment information. Data entered in these fields is not covered by PCI DSS compliance.