Request for Change of Legal Name or Address Instructions
1. Read the instructions below for changing the legal name of an individual or business, or
your residence or business address. Be aware that certain instructions are specific to
certain license types.
2. Print the Name/Address Change Form.
3. Complete the form, and send it to the Department with all required supporting
documentation.
New Jersey Department of Banking & Insurance
Licensing Services, Banking
PO Box 473
Trenton, NJ 08625
E-mail: bliconline@dobi.nj.gov
Phone: 609-292-7272 (follow menu prompts & select #3, then #2, then #1 for Licensing staff)
Fax: 609-633-0822
Change of Legal Name
Individual Name Change:
Attach court order, marriage certificate or other document
Business Name Change:
All License Types
Corporations - enclose a copy of the amended Certificate of Incorporation or
copy of Alternate Name Certificate
Limited Liability Company - enclose a copy of the amended Certificate of
Formation and amended Operating Agreement
Partnership or Sole Proprietorship - enclose a copy of amended or new trade
name certificate
Foreign Corporation - enclose a copy of an amended Certificate of Authority to
do Business in New Jersey
Pawnbrokers, Foreign Money Transmitters, Money Transmitters, and Debt Adjusters
Only
These licensees must enclose the supporting documentation for the name change described
above PLUS:
Enclose an original executed rider to the surety bond reflecting the amended name and /or
the addition or deletion of a new alternate name.
Business Address Change
All License Types
Complete the change of address information on the Name/Address Change Form
Home Repair Contractors Only
Enclose a copy of the deed, lease or rental agreement for the new business location (even
if a residence).
Enclose (2) two photographs of the location in which the business sign is visible OR if a
residence, copies of letters to the post office and telephone company advising of the use
of the new residence as a home repair business.
Check Cashers Only
Enclose a copy of the deed, lease or rental agreement for the new business location –
Note: The agreement MUST be executed between the licensee and the landlord/property
owner. If a sublease is involved, there MUST be written evidence of the landlord's
knowledge and acceptance of the subleasing arrangement
Enclose (4) four photographs of the location – two exterior and two interior
Provide a written physical description of the location to be licensed
Provide evidence of compliance with local zoning requirements, specifically identifying
that a check cashing operation may be located at the proposed site, in the form of a letter
from the local zoning officer
Identify any other businesses being conducted or intended to be conducted at the office
location to be licensed. Note: N.J.S.A.17:15A-47(f) states that a check casher is
prohibited from engaging in business other than a business which primarily provides
financial services at an office or mobile office. The statement providing this information
must be notarized and must fully describe the nature and scope of any other businesses
and how such other businesses will be physically separated from the proposed check
cashing business.
Enclose a certified survey demonstrating that the proposed location is NOT within 2,500
feet of any other existing licensed check casher principal or branch office location –
Note: Documentation MUST clearly state that there are NO check cashing offices within
2,500 feet
Pawnbrokers, Foreign Money Transmitters, Money Transmitters, and Debt Adjusters
Only
These licensees must enclose the supporting documentation for the address change
described above PLUS:
Enclose an original executed rider to the surety bond reflecting the new business address.
Banking Licensee Change of Legal Name and/or Address Form
Print and Complete this form NO FEE REQUIRED
Submit all required attachments Return completed form to the address listed
below
License Ref. No: ___________________ Effective Date of Change:____________________
(located in upper right corner of license)
For Change of Name: (check which item applies)
Change in Business Name: Adding Alternate Name: Deleting Alternate Name:
For Business Name Change, see detailed instructions for information regarding required supporting documentation.
Change in Individual Legal Name: Attach court order, marriage certificate or other document
If adding Alternate Name, indicate whether name will be used at all locations or only the main
and specified offices:
all locations: main office and only below specified location(s):
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________
For Change of Address: (check which address is being changed)
Business Address: Mailing Address: Residence Address:
If Business Address, see detailed instructions for information regarding any required supporting documentation.
Please enter Name and/or Address Information
Name: _________________________________________________________________
__________________________________________________________________
Bldg/Suite/Apt:___________________________________________________________
Street Address: __________________________________________________________
PO Box: _______________________________________________________________
City: _______________________________ State: ________________Zip: _________
County: _____________________________ (if New Jersey)
Return to: New Jersey Department of Banking and Insurance
Licensing Services, Banking
PO Box 473
Trenton, NJ 08625
NameAddChForm1011