State of Ohio
Board Home Page Link
blank
Address and Information Change Form
For Use by Ohio Certified Public Accountants and Public Accountants

This form is designed for persons who wish to change their information on file with the Board office.

 E-Mail Address Required) 
 
Check all applicable boxes below
 
Home Address Change
Business Address Change
Telephone Number change
 
Mail Preference Send Mail to Business Address Send Mail to Home Address

   Name: Last First Middle
   Licensee ID Number Social Security Number (optional)
   Current Home Address
   City State Zip Code County
   Old Home Address
   City State Zip Code
   Current Firm name
   Business Address
   City State Zip Code County
   Old Business Name
   Old Business Address
   City State Zip Code
   Telephone #1:Business Cellphone
   Telephone #2:Business Cellphone