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Department of Licensing and Consumer Protection

1100 4th Street, SW, Washington, DC 20024

(202) 671-4500


Notice of Business License Insurance and Bond Modification

Certain Basic Business licensees are required to maintain the insurance and bond coverage as specified in the D.C. Municipal Regulations. Additionally, the Department of Licensing and Consumer Protection must be notified of any cancellation and/or update to any insurance and bonding policies associated with an existing Basic Business License. You may use this form to notify the Department of any changes to insurance and/or bond policies.

Learn more about insurance and bonding requirements:

Insured's Premise Address (Location of Business Operation)

Checkbox/Radio Group

Upload File(s) Bond Cancellation

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Upload File(s) Bond Update

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Upload File(s) Insurance Policy Cancellation

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Upload File(s) Insurance Policy Update

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Insurance/Bond Company Information

Full Name of Person Providing Notice

I certify that the above statements on this application are true and complete to the best knowledge and belief. I agree to comply with all applicable laws and regulations of the District of Columbia. I/We understand that, anyone who makes a false statement on this form can be criminally prosecuted; and, if convicted, fined up to $1000, imprisoned up to 180 days, or both, under D.C. Official Code § 22-2405.

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