Notice of Billing Address Change (BBL Only)

You may use this form to notify the Department of Licensing and Consumer Protection (the Department) of a billing/mailing address change. Upon receipt by the Department, the specified Basic Business License (BBL) will be updated with the provided information within (72) seven-two hours.It is the responsibility of the licensee to notify the Department’s Business Licensing Division of any changes to the billing/email information to avoid non-receipt of important communications. Failure to provide timely notification may result in accrual of late and/or penalty fees.If you are submitting this notification close to your BBL’s expiration date, you are encouraged to contact the Business Licensing Division, (202) 442-4311 for a renewal assessment.

***PLEASE NOTE THAT BY COMPLETING, SUBMITTING AND SIGNING THIS FORM, YOU CONFIRM YOUR AUTHORITY TO AFFECT A CHANGE TO THIS BASIC BUSINESS LICENSE.***

How many Basic Business Licenses are you updating? NOTE: If updating multiple BBLs, the BBLs must have the same owner, tax number, and new billing address.

2-5

6-10

#1 BBL Number (8- or 12-digit number in the upper righthand corner of your Basic Business License)

#2 BBL Number

#2 BBL Number (If applicable)

#3 BBL Number (If applicable)

#4 BBL Number (If applicable)

#5 BBL Number (If applicable)

#6 BBL Number

#7 BBL Number (If applicable)

#8 BBL Number (If applicable)

#9 BBL Number (If applicable)

#10 BBL Number (If applicable)

Name of Business (Name on BBL)

Licensee Trade Name (if applicable)

Business' Tax Number (Numerical characters only)

Select the Billing information to be Updated. (Select all that apply)

Billing Contact

Billing Address

Billing Phone Number

Billing Email Address

New Billing/Mailing Phone Number

New Billing/Mailing Email Address

Are you a Sole Proprietor who wants to update your Resident Agent information?

Select the Resident Agent information to be Updated. (Select all that apply)

Resident Agent Contact

Resident Agent Address

Resident Agent Phone Number

Resident Email Address

New Resident Agent Phone Number

New Resident Agent Email Address

Title of Requestor

Requestor's Phone Number

Requestor's Email Address

Upload Your Basic Business License.

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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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First Name

Last Name

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I agree to electronically sign and to create a legally binding contract between the other party and myself, or the entity I am authorized to represent.

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