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  7:42:17 PM 4/20/2014
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Change of Officer/Stockholder/Amended Corporate Name

This application is used to change the officers, stockholders or corporate name of an existing license.

Application Requirements:
 
  • DISCLAIMER: Applicants may be required to provide some or all of the following (any additional requirements are listed in the form instructions):
  • FEE: There is no fee to change the officers, stockholders or corporate name.
  • APPLICATION: Complete form DBPR ABT-6004 by clicking on "Printable Application" at the bottom of this page (detailed instructions included). If you already have a copy of the detailed instructions, you may prefer to obtain the form without the instructions in ABT-6004 PDF or ABT-6004 Word format.
  • FINGERPRINTS: If applicable, In-State residents should visit the Florida Department of Law Enforcement's web site to get a list of approved Livescan Device Vendors (a link to the provider list is available through the fingerprint FAQs). You must be able to provide the Florida Division of Alcoholic Beverages and Tobacco's Originating Agency Identifier Number (ORI#) which is FL920150Z. Out-of-State applicants must contact the division to obtain a fingerprint card. To learn more about fingerprinting, please visit our fingerprint FAQs.

  • ARREST DISPOSITION: Provide certified copies of arrest disposition, if applicable.
  • MORAL CHARACTER: Provide mitigation of moral character, if applicable.
  • SECRETARY OF STATE: Submit Secretary of State/Certificate of Status, if applicable.
  • DOR: Obtain and submit Department of Revenue clearance.
  • FEIN: Submit Federal Employer's Identification Number (FEIN), if applicable.
  • SSN: Submit Social Security Number (SSN), if applicable.
  • PARTNER, OFFICER OR STOCKHOLDER: Submit Partner, Officer or Stockholder information, if applicable.
  • MORE INFORMATION: Learn more details about the application requirements and submittal process.
  • SUBMIT APPLICATION: Submit your application to one of our district offices by mail, hand delivery or contact the local office to make an appointment.



Application Currently Unavailable Using Online Services


Apply Using a Printable Application
1940 North Monroe Street, Tallahassee FL 32399 :: Email: Customer Contact Center :: Customer Contact Center: 850.487.1395