Online Address Change Form

To change your address of record, please provide the following information and endorse with the last four digits of your Social Security number. Licenses are not automatically reprinted when a change of address has been requested. You must submit a Request for Duplicate License form with the appropriate fee to request a replacement license. Click here to download the Request for Duplicate License form.

You cannot change your name online. Click here to download the Change of Name form.

412. Address Change for Engineers and Land Surveyors.

Each person who is an applicant for, or a holder of, a certificate or license issued by the Board under provisions of the Professional Engineers Act or the Professional Land Surveyors' Act shall file his/her address with the Board office. Within thirty (30) days after changing addresses, he/she shall notify the Board office of such change.

3009. Address Change for Geologists and Geophysicists.

Each person who is an applicant for or a holder of a certificate license issued by the Board shall file his or her address of record with the Board. Within thirty (30) days after any change to his or her address of record, he or she shall notify the Board in writing of such change.

Please complete the following information. Note: Licensees must include the license number. If you do not know your license number, you may click here to obtain it from the Verify a License screen.

Address Change Form
Fields marked with an asterisk (*) are mandatory.
*If a Licensee
Additional License (if applicable)
Additional License (if applicable)
If an Applicant:
Personal Information
*Old Mailing Address:
*New Mailing Address:
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