Change your Name or Address

For Information about changing your address with the Department or changing your name. If you have moved, but still reside in the same state, you can submit the address change electronically using one of the following services:

  NIPR has an electronic service called Address Change Request (ACR). This service will allow you to electronically complete and submit address changes on-line and update one, multiple, or all states with a single entry. There are no fees charged for this service and allows you to provide timely notification to the Department.

OR

 SIRCON has an electronic service called Sircon Edge.  This service will allow you to electronically complete and submit address changes to the Department. There is a $2.25 charge for this service and allows you to provide timely notification to the Department.

If you have moved out of your previous home state to another state, you must submit the address change form (CLICK HERE FOR FORM). Please fax the form to (802) 828-1633. In ADDITION to the form, please enclose a Home State Certification Letter from your new state of residence, (only required if your new home state does not report licensing information into the Producer Data Base (PDB).

If you need to change your name with the Department, please submit it in writing along with a copy of the documentation that supports the name change. You can fax those documents to (802) 828-1633.

• Producer Licensing