Notification of Personnel Name Change Form

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    Easy-Fill Application

    This is an easy-fill form that will walk you through the process to fully and accurately complete this form. Upon completion, you will be required to print and submit the document to CSLB.

    IMPORTANT NOTES:

    Be sure to use the "Back" and "Next" buttons at the bottom of each page - do not use your browser's back arrow because all of your entered information will be erased and you will have to start over.

    Please type your information directly into the fields of this form. If you copy text from another application or document and paste it into this easy-fill form and the text contains invalid (non-ASCII) characters, they will be removed from the final document.

    Make sure you give yourself enough time to complete the entire form in one sitting. You will not be able to save a partially filled form to complete at a later time.


    To print or order a blank form, please click here to be redirected to CSLB's "Forms and Applications" page.
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    General Information and Instructions

    Changing a Licensee’s Personal Name: Use this easy-fill form if you have recently had a change to your legal name (marriage, a divorce decree, a court decree, or some other legal reason) and need to update your personnel records on your license as required by BPC section 7083. Complete the form in its entirety, including all “new name” boxes even if parts of your new legal name remain the same as before the change. Be sure to enclose a photocopy of the required documentation to verify the name change when you submit the form.

    If you want to change your name as part of the Safe at Home program or to conform with gender identity do not use this form. Please go to Name and Gender Change Notification and Request for Confidentiality (SB 372, 2023) - Department of Consumer Affairs and complete the process via the online portal.

    If your business name on record with CSLB contains your personal name, you can change the business name by submitting an Application to Change Contractors Business Name form with the proper fees after completing your personnel name change.

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    Section 1

    Complete all fields:


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    Section 2

    Select the supporting documents you will submit with your form:

    (One of the following photocopied documents MUST be enclosed)

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    Review and Edit

    Please Review the Following Information

    This is a summary of the information that will print on your form. If there are any corrections that need to be made, please choose the Edit button or Back button below to make the change now, as you will not have the opportunity to do so after you submit this page.

    Agree To Complete

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    Completion Instructions

    NOTICE: This document is not submitted to or saved by CSLB. You must either print it now, save it to your computer, or email it to your email address to print and mail at a later time.

    Complete these action(s) before mailing your document(s):


    Mail your document(s) along with the application to:
    Contractors State License Board
     P. O. Box 26000
     Sacramento, CA 95826

    PDF

    Select the button below to view and print the document.

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    Email the PDF

    You can email this document to your email address. This will contain the same document as in the pdf view and print link above.

    This process does not save or submit your document to CSLB. If you email the document to your email address, you will still need to follow the instructions to print and mail it to the CSLB.

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