Application to Report Change of Title for Current Officer or Personnel of Existing Corporate or Limited Liability Company License

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    Easy-Fill Application

    This is an Easy-Fill form that will walk you through the process to fully and accurately complete this form. Upon completion, you will be required to print and submit the document to CSLB.

    IMPORTANT NOTES:

    Be sure to use the "Back" and "Next" buttons at the bottom of each page - do not use your browser's back arrow because all of your entered information will be erased and you will have to start over.

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    To print or order a blank form, please click here to be redirected to CSLB's "Forms and Applications" page.
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    Use this application only to change the title of a current officer or member of the personnel already on record for an existing corporate license (officer only) or for an existing limited liability company (LLC) license (officer, manager, or member).

    Use one application for each officer or personnel title change. Each additional officer or personnel must use a separate application.

    If you have additional licenses with the same corporate or LLC registration number (as issued by the California Secretary of State and listed in box 3 in Section 1), you must submit a copy of this application for each license. All licenses using the same corporate or LLC registration number must show the same officers, managers, and/or members as their personnel of record.

    To add new personnel to an existing corporate or limited liability company license, use form 13A-7 - Application to Add New Personnel to Existing Corporate or Limited Liability Company License.

    To disassociate personnel from an existing license, including a responsible managing officer (RMO), responsible managing manager, responsible managing member, or responsible managing employee (RME), use form 13M-5 - Disassociation Request.

    To replace a current qualifying individual (RMO, responsible managing manager, responsible managing member, or RME) on an existing license, use form 13A-2a - Application for Replacing the Qualifying Individual.

    SECTION 1 - BUSINESS NAME AND ADDRESS

    Business Name

    Please provide the full legal business name as it appears on the CSLB license. P.O. Boxes and private mail boxes (PMB) are not acceptable for the street address. Also include the license number as issued by CSLB and the registration number as issued by the California Secretary of State.

    *BUSINESS MAILING ADDRESS
    *BUSINESS STREET ADDRESS

    * Required Entry

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    SECTION 2 - CORPORATE OR LLC PERSONNEL'S FULL LEGAL NAME, ADDRESS, AND NEW TITLE

    PERSONNEL'S FULL LEGAL NAME AND TITLE

    Please provide the full legal name of the personnel who is changing title.

    Must be hand written on form
    *BUSINESS ENTITY:

    *TITLE OR POSITION Officer titles - president, secretary, and treasurer for California corporations and for LLCs that have officers; president only for foreign corporations. All LLCs must have at least one (1) manager or member.


    STATE TAX AND OTHER OBLIGATIONS NOTICE

    The State Board of Equalization and Franchise Tax Board may share taxpayer information with CSLB. You are obligated to pay your state tax obligation. CSLB may suspend or refuse to issue, reactivate, reinstate, or renew a license if your state tax obligation, child support obligation, or any outstanding final liability to CSLB, the Department of Industrial Relations, or the Employment Development Department is not paid. (BPC sections 30, 31, and 7145.5)

    * Required Entry

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    Review and Edit

    Please Review the Following Information

    This is a summary of the information that will print on your form. If there are any corrections that need to be made, please choose the Edit button or Back button below to make the change now, as you will not have the opportunity to do so after you submit this page.

    MAILING ADDRESS

    STREET ADDRESS

    Agree To Complete

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    Completion Instructions

    NOTICE: This document is not submitted to or saved by CSLB. You must either print it now, save it to your computer, or email it to your email address to print and mail at a later time.


    Mail your document(s) along with the application to:

    Contractors State License Board
     P. O. Box 26000
     Sacramento, CA 95826

    PDF

    Select the button below to view and print the document.

    Note: If you have a problem opening the PDF file, click this link for some PDF file troubleshooting steps.

    Email the PDF

    You can email this document to your email address. This will contain the same document as in the pdf view and print link above.

    This process does not save or submit your document to CSLB. If you email the document to your email address, you will still need to follow the instructions to print and mail it to the CSLB.

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