Transcription of APPLICATION FOR NAME CHANGE before …
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Example: air traffic controller
APPLICATION FOR NAME CHANGE before …
BOARD FOR LICENSING CONTRACTOR 500 JAMES ROBERTSON PARKWAY NASHVILLE, TENNESSEE 37243-1150 (615) 741-8307 or Fax (615) 532-2868 Email: - ATTN Revision Section APPLICATION FOR name CHANGE ID#: 000_____ Expiration Date:_____/_____/_____ LICENSE name : _ Licensed Mode of Operation: _ __Sole Prop. ___Corporation __Partnership __LLC Will Mode of Operation remain the same? ___Yes ____*No If No , do not complete NameChange APPLICATION :_____ (Address CHANGE :___Yes - Address above indicates new address / ___No - There has been no CHANGE ) : (_____)_____-_____ FAX:(_____) : / OFFICERS (approved by Board prior to CHANGE ):(Ownership) (Ownership) History, Felony Convictions or Unpaid Judgments? ___No ___*Yes Attach ExplanationNEW COMPANY name INFORMATION LICENSE name :_____(Note: Mode of Operation must be the same as currently licensed as indicated above) in Owners or Officers?
Send the completed “Name Change” application to the Board office by the deadline date, which is the last day of the month prior to a Board meeting. For example, to apply for a revision at the November Board
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