Edit, Download, and Sign the Illinois Name and Address Change Form
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How do I fill this out?
To fill out this form, begin by providing your current contact information as shown on your license. Next, include the new mailing address where you'll be receiving communications. Lastly, if there's a name change, attach the required certified document and provide your new name.
How to fill out the Illinois Name and Address Change Form?
1
Gather your current contact information and new address details.
2
Fill in the form with the accurate updated information.
3
Provide a certified copy of the document supporting your name change if applicable.
4
Sign and date the form to verify the information provided.
5
Submit the form through email or mail to the specified address.
Who needs the Illinois Name and Address Change Form?
1
Individuals changing their address for personal reasons.
2
Married individuals seeking to update their name post-marriage.
3
Divorced individuals needing to revert to a previous name.
4
People who have changed their name through legal means and need to update official records.
5
Professionals requiring updated licensing information due to changes.
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What are the instructions for submitting this form?
Submit your completed Name and Address Change Form via email to fpr.lmu@illinois.gov or mail it to the Illinois Department of Financial and Professional Regulation, Division of Professional Regulation at 320 West Washington Street, Springfield, Illinois 62786. Ensure to only send copies of any original documents, not the originals. If you have further questions, call 800-560-6420 for assistance.
What are the important dates for this form in 2024 and 2025?
The Illinois Name and Address Change Form must be submitted as soon as possible when changes occur. Ensure any updates are completed before critical deadlines for the respective authorities in 2024 and 2025.
What is the purpose of this form?
The Illinois Name and Address Change Form serves a crucial purpose in maintaining up-to-date information for individuals licensed under the Department of Financial Regulation. By submitting this form, individuals ensure that their contact details remain on record, allowing for accurate communication. It is vital for personal identification and verification processes and helps prevent potential issues related to missed notifications.
Tell me about this form and its components and fields line-by-line.
- 1. License Number: The unique identifier assigned to each license holder.
- 2. Name: The current legal name as per the license.
- 3. SSN or ITIN: Social Security Number or Individual Taxpayer Identification Number.
- 4. Address: Current residential address that must be updated.
- 5. Updated Address Information: New street address and contact information.
- 6. Name Change Information: Details regarding any name change and supporting documents.
What happens if I fail to submit this form?
If you fail to submit this form, your records will remain outdated, causing potential issues with communication from the Department. This could lead to delays in processing any licenses or notifications and create challenges in verifying your identity. Therefore, timely submission is crucial to prevent any complications.
- Outdated Contact Information: Failure to update may result in missed communications regarding your license.
- License Processing Delays: An outdated form could lead to delays in reissuing or renewing licenses.
- Identity Verification Challenges: Ensuring accurate records is essential for identity verification during official transactions.
How do I know when to use this form?
- 1. Marriage: A name change due to marriage necessitates this form.
- 2. Divorce: Individuals looking to revert to a previous name after divorce should submit this.
- 3. Relocation: Anyone moving to a new address must update their records via this form.
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