CHANGE OF ADDRESS NOTIFICATION Use this page to notify the Board of your address change after you submit your Declaration/Application. We will include this page in your file after we receive it. Further, we will arrange to send all future correspondence to the address shown below. NOTE: We do not accept address change notification by electronic mail. Send this page to either address below: Mailing Address: Texas Board of Law Examiners P. O. Box 13486 Austin, Texas 78711-3486 Physical Address: Texas Board of Law Examiners 205 West 14th Street, 5th Floor Austin, Texas 78701 Or send this page by facsimile to: (512) 463-5300 FILE LINE - - DO NOT WRITE ABOVE THIS LINE - - DO NOT DETACH Address Change will be effective immediately upon receipt in our office. FOR OFFICE USE ONLY Your Name: _________________________________________________ New Address: ________________________________________________ City/State/Zip: ________________________________________________ New Home Telephone: ___________________________ Work / Mobile Telephone: __________________________ (please specify) Signature (required): ____________________________________________ Date: __________________________ E-mail Address (optional): ________________________________________ SSN: __________________________ Your status: _____ Declarant ______ Candidate for Admission without exam (check one) _____ Candidate for the February exam ______ Candidate for the July exam address change.pdf (10/2005) American LegalNet, Inc. www.USCourtForms.com