1100 4th Street, SW, Washington, DC 20024
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)
Upload File(s) Bond Cancellation
Upload File(s) Bond Update
Upload File(s) Insurance Policy Cancellation
Upload File(s) Insurance Policy Update
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.
DC INSPECTOR GENERAL HOTLINE: If you are aware of corruption, fraud, waste, abuse, or mismanagement involving any DC Government agency, official or program, contact the Office of the Inspector General (OIG) at 202-727-0267 or 1-800 521-1639 (toll free). All reports are confidential and you may remain anonymous by law. Government employees are protected from reprisals or retaliation by their employers for reporting to the OIG. The information you provide may result in an investigation leading to administrative action, civil penalties, or criminal prosecution in appropriate cases.