STATE OF ALASKA 
                                                                                                      BUS 
                        Department of Commerce, Community and Economic Development 
                                                                                                           
                        Division of Corporations, Business and Professional Licensing 
                        BUSINESS LICENSE PROGRAM                                                           
                        P.O. Box 110806 
                        Juneau, Alaska 99811-0806                                                          
                        Phone: (907) 465-2550                                                              
                        Website: www. commerce.alaska.gov/occ                                              
                                                                                                           
                                                                                              OFFICE USE ONLY
                         BUSINESS LICENSE CHANGE OF ADDRESS 
This form will only notify the Business Licensing Section when there is a business license change of address.  Separate 
notices are required to notify the Corporation Section and the Professional License Section. 
1. Business Name: 
 
Business License #: 

2.  Previous Mailing Address: 
 
City:                                                         State:                         ZIP Code:

3. New Mailing Address: 
 
City:                                                         State:                         ZIP Code:

4.  Previous Physical Address: 
 
City:                                                         State:                         ZIP Code:

5. New Physical Address: 
 
City:                                                         State:                         ZIP Code:

6.  Previous Phone Number:                           7. New Phone Number: 
   
Name of person submitting address change: 
Printed                                                                                       
                                                                            Title: 
Name:                                                                                         
                                                                                              
Signature:                                                                  Date: 
                                                                                              
There is no fee for this filing. 
State of Alaska 
Business Licensing Section 
PO Box 110806 
Juneau AK 99811-0806 
For more information on how to change an address with the Corporations Section and the Professional License Section 
go to www.commerce.alaska.gov/occ/. 
     Click Corporations Section, Forms & Fees, Other Documents, and select Entity Address Change. 
     Click Professional Licensing Section, click on a profession in the drop-down list and email the Licensing Examiner 
      for your profession. 
For more information on Business Licensing go to the above website and click on Business License Section. 
08-4054 (Rev. 01/24/13)