Please complete the below form to its entirety. Forms not completed to their entirety will not be accepted and deemed incomplete by the division. A licensee shall submit to the division an application form for an amended license or application, submit any required documentation associated with the change and must obtain approval from the division, prior to implementing any type of amendment. Required documentation for specific amendments are listed at the end of this document.
Manage Cookie Consent
The technical storage or access is strictly necessary for the legitimate purpose of enabling the use of a specific service explicitly requested by the subscriber or user, or for the sole purpose of carrying out the transmission of a communication over an electronic communications network.
The technical storage or access is necessary for the legitimate purpose of storing preferences that are not requested by the subscriber or user.
The technical storage or access that is used exclusively for statistical purposes.The technical storage or access that is used exclusively for anonymous statistical purposes. Without a subpoena, voluntary compliance on the part of your Internet Service Provider, or additional records from a third party, information stored or retrieved for this purpose alone cannot usually be used to identify you.
The technical storage or access is required to create user profiles to send advertising, or to track the user on a website or across several websites for similar marketing purposes.