This form is used to: Request inactive status; to transfer additional business to primary license; or, to change business name (only for Name Change Amendments, Adding a Fictitious Name, Conversion from Corporation to LLC or Conversion from LLC to Corporation). This will not transfer your license to a new business. If you want to qualify a new business choose the transfer transaction.
Application Requirements:
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.
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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