| THE OFFICIAL SITE OF THE FLORIDA DEPARTMENT OF BUSINESS & PROFESSIONAL REGULATION |
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12:40:47 PM 5/31/2023 |
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Request for Name Change, Address Change, or Status Change (BCAIB 6)
Individuals must complete this form when requesting a name change, address change, or when requesting to set their license from active to inactive status or from inactive to active status.
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- FEE: Pay the required fee as provided in the application. Make check payable to the Department of Business and Professional Regulation.
- APPLICATION: Complete the application by clicking on the "Printable Application" link at the bottom of the page.
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| If you have questions or need assistance in completing this application, please call the Customer Contact Center at 850.487.1395 or use our convenient contact form. |
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:: Email: :: Customer Contact Center: 850.487.1395
The State of Florida is an AA/EEO employer.
Under Florida law, email addresses are public records. If you do not want your email address released in response to a public-records request, do not send electronic mail to this entity. Instead, contact the office by phone or by traditional mail.
If you have any questions, please contact 850.487.1395. *Pursuant to Section 455.275(1), Florida Statutes, effective October 1, 2012, licensees licensed under Chapter 455, F.S. must provide the Department with an email address if they have one.
The emails provided may be used for official communication with the licensee. However email addresses are public record. If you do not wish to supply a personal address, please provide the Department with an email address which can be made available to the public.
Please see our page to determine if you are affected by this change.
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