ALABAMA STATE BOARD OF PUBLIC ACCOUNTANCY
On-Line Change of Information Form
for Non-Licensee Owners

Use this form to submit changes of information for individual Non-Licensee Owners (NLO) to the Alabama State Board of Public Accountancy via the Internet.  Fields with light yellow backgrounds are required fields. If certain field information is to be deleted but not replaced, enter DELETE in the appropriate field box.

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

**Please Note** Submitted changes are not reflected immediately on the on-line search function.  Updates to the on-line database are usually made at least once per month but occasionally there may be a delay of up to six weeks.  

Date: 

Registration Number:       Last 4 digits of Social Security No.

Name (first middle last): 

Person submitting information if not the NLO listed above:

Enter into the fields below the information you are requesting to be changed.  Leave blank any fields that should remain unchanged.

Preferred Mailing Address    
Line 1:
Line 2:
City:    State:   Zip:
Out-of-country address:
Preferred Telephone Number (include area code and any extension):

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 and any extension):

The information for my Alternate Mailing Address is my  Home    Work  address.

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

  Additional Comments:

Review the information you have entered above and then send by clicking on the "Submit to ASBPA" button below.  To clear all information you have entered, click on the "Reset Form" button.