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Address Change? Let Us Know!

Licensees, please check the mailing label on the upper half of this page. Idaho Accountancy Rule 302 requires license holders to notify the Board in writing within 30 days of any change of address, business connection, or employer.

Licensee Name

________________________________________________

License #

_____________

Daytime Phone (

) __________________

New Mailing Address ___________________________________________ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __________________________ State _____________ Zip _________ _ _ _ _ City

Employer Name

____________________________

New? Yes No

Signature

_______________________________________

Date

___________

Mail to:

OR FAX :

208-334-2615

OR E-MAIL:

isba@boa.state.id.us

Idaho State Board of Accountancy PO Box 83720 Boise, Idaho 83720-0002

ISBA July 2000 Page 6

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