Business Registration Certificate Amendment Form
Please fill out the form to request an amendment to your business registration certificate.
Business Name
*
Business Registration Number
*
Date of Original Registration
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Type of Amendment Requested
*
Please Select
Change of Business Name
Change of Business Address
Change of Ownership
Change of Business Activities
Other
Please specify details of the amendment
*
Authorized Person Full Name
*
First Name
Last Name
Authorized Person Contact Email
*
example@example.com
Authorized Person Contact Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Submit
Should be Empty: