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Administrative Change Request Form

  1. Permits are not transferable. If this business has a new owner, a new permit application is required- please contact (602) 506-6824 for more information.

  2. This form may only be used to change/update an owner mailing address, billing mailing address, or business name.

  3. The Permit Owner Name refers to the entity or sole proprietor that owns the establishment. Management Companies may not be listed as the Owner.

  4. Business Information

  5. Update / Change

  6. Update / Change

  7. Leave This Blank:

  8. This field is not part of the form submission.