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.  Please complete the entire form.

**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 information into all the fields below.  If no information is available enter "None" into the field.

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:  

  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.