Get Request For Address Change Failure To Provide Any Requested Data May Prevent Or Significantly Delay

This guide provides detailed instructions on completing the Request For Address Change form online. By following these steps, you will ensure that your request is accurately submitted, allowing for efficient processing.

Follow the steps to successfully complete your address change request.

1. Click ‘Get Form’ button to access the Request For Address Change form and open it in the online editor.
2. In Section A, provide your personal information. Select your license type (PT or PTA), then enter your first name, middle name, last name, and date of birth. Include the last four digits of your Social Security Number, work phone, daytime phone, and email address.
3. Move to Section B to update your Address of Record. Provide the previous address of record, including street or P.O. Box, city, state, zip, and country. Then enter the new or correct address of record.
4. In Section C, you will update your residence address. If your residence address is the same as your address of record, check the box. If not, provide the previous residence address, including street, city, state, zip, and country, followed by your new or correct residence address.
5. Proceed to Section D, where you will update your email address. Enter the previous email address and then your new or correct email address.
6. In Section E, you will declare that the information provided is true and correct. Ensure you sign the declaration and include the date next to your signature.
7. After completing the form, review all entered information for accuracy. Save your changes, and once everything is verified, you can download, print, or share the form as needed.

Complete your address change request form online today to avoid delays!