R9-16-622. Changes Affecting a Certificate or Certificate Holder

A. A certificate holder shall notify the Department in writing, within 30 calendar days after the effective date of a change in: 1. The certificate holder’s residential address, mailing address, or email address, including the new residential address, mailing address, or email address; 2. The certificate holder’s name; or 3. The certificate holder’s employer, including the name and address of the new employer. B. A certificate holder notifying the Department of a name change according to subsection (A)(2) shall request a revised certificate issued with the certificate holder’s new name by submitting to the Department: 1. An application for a revised certificate, in a Department- provided format, that includes: a. The certificate holder’s name and address as included in Department records, b. The certificate holder’s certificate number and expiration date, c. The certificate holder’s new name, and d. The certificate holder’s signature and date of signature; 2. A copy of the legal document establishing the certificate holder’s new name; and 3. The revised certificate fee in R9-16-623. C. A certificate holder may submit to the Department, either as a separate written document or as part of the renewal application, a signed and dated request to transfer to inactive status or retirement status under A.R.S. § 32-2816(F).