ALABAMA STATE BOARD OF PUBLIC ACCOUNTANCY
On-Line Change of Information Form
for Registered Test Candidates

Test candidates may use this form to submit changes of information.  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.

**Please Note** 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).

This is not the form to be used to register to take the Uniform CPA Examination!

Date: 

Last 4 digits of Soc Security No.

Name (first middle last): 

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

Home Mailing Address    
 Line 1:
 Line 2:
 City:    State:   Zip:
 Telephone (include area code):

Employer and Business Mailing Address
 Employer:   
Title:            
 Address:     
 Add Line 2:
 City:            State:   Zip:
 Telephone (include area code and any extension):

Email address:   
Fax Number:  

Check this box if you are no longer employed and wish to have your employment information removed

  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.