Use this form to submit changes of information for individual Non-Licensee Owners (NLO) to the Alabama State Board of Public Accountancy.
If certain field information is to be deleted but not replaced, enter "DELETE" in the appropriate field box.

Name changes cannot be made online. Changes to your name must be mailed to the Board
along with legal documentation (e.g., copy of a marriage certificate).

NOTE: Submitted changes are not reflected immediately on the online search function.
Updates to the online search function are usually made at least once per month.
 


Date:   

Registration No.:            Last 4 digits of Soc Security No.:   

Name (first middle last):   

Person submitting information if not the NLO listed above:


Please complete entire form, if possible.


Preferred Mailing Address

    
 Line 1:  

 Line 2:  

     City:   State:   Zip:

Out-of-country address:

Preferred Telephone Number (include area code):   Ext:

The information for my Preferred Mailing Address is my:     

 

Alternate Mailing Address


 Line 1:  

 Line 2:  

     City:     State:   Zip:

Out-of-country address:

Alternate Telephone Number (include area code):   Ext:

The information for my Alternate Mailing Address is my:     



 Email address:    Fax Number:

  CPA/PA Firm:  

         Job Title:  

 Ownership %:             Work Time %:  

Check this box if you are no longer a Non-Licensee Owner of the above-named CPA/PA firm

 
Comments:


Review the information you have entered above.  
To submit your change of information, click the "Submit to ASBPA" button. 
To clear all information you have entered, click the "Reset Form" button.

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