Alabama State Board of Public Accountancy

Use this form to submit changes of information for individual Non-Licensee Owners (NLO) to the Alabama State Board of Public Accountancy.

Please complete the entire form to ensure all of your contact information is up to date.

Name changes cannot be submitted using this form. Changes to your name must be emailed to info.change@asbpa.alabama.gov along with any legal documentation (e.g., copy of a marriage certificate).

NOTE: Submitted changes are not reflected immediately on the online search function.

Date: * Required * Please enter Date format MM-DD-YYYY

NLO #: * Required Last 4 digits of SSN: * Enter last 4 digits of SSN Enter last 4 digits of SSN

Name (first middle last): * Required

Person submitting information if not the NLO listed above:

Preferred Mailing Address

Line 1:

Line 2:

     City:   State: Zip:

Out-of-country address:

Preferred Telephone Number (include area code): Ext: Enter Ext in digits

The information for my Preferred Mailing Address is my: Home     Work Address

Alternate Mailing Address

Line 1:

Line 2:

     City:   State: Zip:

Out-of-country address:

Alternate Telephone Number (include area code): Ext:
Enter enter Ext in digits
The information for my Alternate Mailing Address is my: Home     Work Address

Email address: Enter Email (name@domain.gov) 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.

If your form will not submit, please make sure all required fields have been completed.