Get Change Of Address Or Name Or Duplicate License - Mass.gov - Mass

This guide provides a comprehensive overview of how to fill out the Change Of Address Or Name Or Duplicate License form for the Commonwealth of Massachusetts. Follow these steps to ensure your application is completed correctly and efficiently.

Follow the steps to fill out the form accurately and promptly.

1. Press the ‘Get Form’ button to obtain the form and open it in your preferred document editor.
2. Indicate which changes you are requesting by checking the relevant box: Name Change, Address Change, or Duplicate License.
3. In the first section, fill in the information as it currently appears on your license. Provide your name, address, city/town, state, zip code, board code, and license number.
4. In the second section, type the new information you wish to appear on your updated license, including your new name and address.
5. If applicable, circle other professional licenses you hold, such as Nursing or Dentistry, to ensure accurate processing.
6. Enter your Social Security Number in the mandatory field.
7. If your license has been lost or stolen, check the appropriate box to notify the board.
8. Sign the form to attest that the information provided is truthful and complete. Include your telephone number for any follow-up communication.
9. Verify you have included the correct fee for your request: $17.00 for a duplicate license, $27.00 for a name change with a new license, and no fee for address changes.
10. Print or download the completed form and prepare it for mailing. Make your payment to the Commonwealth of MA using a check or money order and mail it to the address indicated.

Complete your document changes online today for a smoother experience.