Change of Name or Request for Duplicate License for Board of State Examiners of Plumbers and Gas FittersThis PDF form maybe used to request a name change, address change or a duplicate license.
Note: This is not meant to be an interactive form.
- The Online Change of Address feature allows you to change your address of record listed in our database. To use this function, you must provide certain information for authorization.
- Appeals, Special Permissions, Variances
- Interactive PDF Version - can be filled out and printed using the Adobe Acrobat Reader