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Change Of Business Name Or Change Of Mailing Address Application Form. This is a Florida form and can be use in Department Of Business And Professional Regulation Statewide.
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Tags: Change Of Business Name Or Change Of Mailing Address Application, ABT-6009, Florida Statewide, Department Of Business And Professional Regulation
INSTRUCTIONS FOR COMPLETING
DBPR ABT- 6009
DIVISION OF ALCOHOLIC BEVERAGES & TOBACCO
CHANGE OF BUSINESS NAME OR CHANGE OF MAILING ADDRESS APPLICATION
If you have any questions or need assistance in completing this application, please contact the
Department of Business and Professional Regulation or your local district office. Please submit your
completed application to your local district office.
GENERAL INSTRUCTIONS
Please complete all information. All questions are applicable and must be answered fully and truthfully.
You must provide an original application. All signatures must be original.
Contact Person
All communications regarding your application will be sent to the applicant at the mailing address
provided. If you would like us to communicate with someone other than the applicant, please provide the
information for that person in the section labeled “License Information”. If you have appointed a person to
act on your behalf and make changes to the application paperwork, please provide a copy of the Power of
Attorney indicating such person is authorized to make changes on your behalf. If you have appointed an
attorney to act on your behalf and make changes to the application paperwork, please provide a copy of
the letter of representation.
APPLICATION CHECKLIST
U
Select the appropriate transaction below and comply with the corresponding application requirements.
TRANSACTION
Change of Business
Name (Fee Required)
Change of Mailing
Address
(No Fee Required)
APPLICATION REQUIREMENTS
Pay $10 fee (make check payable to the Division of Alcoholic
Beverages and Tobacco)
Complete DBPR ABT-6009 Division of Alcoholic Beverages and
Tobacco Change of Business Name or Change of Mailing Address
Application
Complete DBPR ABT-6009 Division of Alcoholic Beverages and
Tobacco Change of Business Name or Change of Mailing Address
Application or you may complete online at:
https://www.myfloridalicense.com/
HTU
Auth. 61A-1.023, FAC
UTH
1
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DBPR ABT-6009 – Division of Alcoholic Beverages and Tobacco
Change of Business Name or Change of Mailing Address Application
STATE OF FLORIDA
DEPARTMENT OF BUSINESS AND PROFESSIONAL
REGULATION
DBPR Form
ABT-6009
Revised 09/2010
If you have any questions or need assistance in completing this application, please contact the
Department of Business and Professional Regulation or your local district office. Please submit your
completed application to your local district office. A District Office Address and Contact Information Sheet
can be found on AB&T’s page of the DBPR web site at the link provided below.
http://www.myflorida.com/dbpr/abt/district_offices/licensing.html
SECTION 1- CHECK TRANSACTION REQUESTED
Transaction Type:
Business Name Change ($10 Fee Required)
Mailing Address Change (No Fee Required)
License/Permit Number
SECTION 2 - CHANGE OF BUSINESS NAME
Series/Type
Full Name of Applicant (This is the name the license is currently issued in)
Old Business Name (D/B/A)
New Business Name (D/B/A)
License/Permit Number
SECTION 3 - CHANGE OF MAILING ADDRESS
Series/Type
Full Name of Applicant (This is the name the license is currently issued in)
New Mailing Address
City
State
Zip Code
SECTION 4 - APPLICANT SIGNATURE
APPLICANT SIGNATURE ________________________________________Date__________________
Contact Person
Telephone Number
E-Mail Address
ABT District Office Received / Date Stamp
Auth. 61A-1.023, FAC
1
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www.FormsWorkFlow.com