Form DBPR AU-4154 "License Maintenance/Status Change Form" - Florida

What Is Form DBPR AU-4154?

This is a legal form that was released by the Florida Department of Business & Professional Regulation - a government authority operating within Florida. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on July 10, 2012;
  • The latest edition provided by the Florida Department of Business & Professional Regulation;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of Form DBPR AU-4154 by clicking the link below or browse more documents and templates provided by the Florida Department of Business & Professional Regulation.

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Download Form DBPR AU-4154 "License Maintenance/Status Change Form" - Florida

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State of Florida
Department of Business and Professional Regulation
Board of Auctioneers
License Maintenance/Status Change Form
Form # DBPR AU-4154
APPLICATION CHECKLIST - IMPORTANT - Submit all items on the checklist below with your
application to ensure faster processing.
TRANSACTION
APPLICATION REQUIREMENTS
Complete Sections I, II and VII
Close Business
Complete Sections I, III and VII.
Address Change
Complete Sections I, III and VII.
Address Change with Issuance of
Submit the $25 fee. Make check payable to the Florida
Updated License
Department of Business and Professional Regulation.
Complete Sections I and VII.
Submit the $25 fee. Make check payable to the Florida
Request Duplicate License
Department of Business and Professional Regulation.
Complete Sections I, IV and VII.
Individuals must submit documentation supporting name
change. See Section IV of Instructions.
Name Change with Issuance of an
Submit the $25 fee. Make check payable to the Florida
Updated License
Department of Business and Professional Regulation.
Complete Sections I, VI and VII.
Submit the $155 fee. Make check payable to the Florida
Renewal Request
Department of Business and Professional Regulation.
 Complete Sections I, V and VII of this form.
 Pay $50 fee if not within renewal period (make check
Set License to Inactive
payable to the Department of Business and Professional
Regulation).
 Complete Sections I, V and VII of this form.
 Pay $50 fee (make check payable to the Department of
Set License to Active
Business and Professional Regulation).
Please mail your completed application, documentation and required fee(s) to:
Department of Business and Professional Regulation
2601 Blair Stone Road
Tallahassee, FL 32399-0783
Instructions
If you have any questions or need assistance in completing this application, please contact the
Department of Business and Professional Regulation, Customer Contact Center, at 850.487.1395.
Application Instructions
a. Section I - Transaction Type
i.
Check only the applicable transaction(s) you are seeking.
b
.
Section II – Close Business
i.
This transaction allows a business to reflect the closed status with the Department.
ii.
The section must be completed by the authorized representative. Mail the completed
application to the address at the top of the form.
iii.
There is no fee for this transaction; however, you must send your license back to the
Department with this form.
c. Section III – Address Change
i.
This transaction allows a business or individual to change their current mailing and/or
physical address.
DBPR AU-4154– Maintenance Form/Status Change
Eff. date: 07/10/2012
Incorporated by Rule: 61-35.005
State of Florida
Department of Business and Professional Regulation
Board of Auctioneers
License Maintenance/Status Change Form
Form # DBPR AU-4154
APPLICATION CHECKLIST - IMPORTANT - Submit all items on the checklist below with your
application to ensure faster processing.
TRANSACTION
APPLICATION REQUIREMENTS
Complete Sections I, II and VII
Close Business
Complete Sections I, III and VII.
Address Change
Complete Sections I, III and VII.
Address Change with Issuance of
Submit the $25 fee. Make check payable to the Florida
Updated License
Department of Business and Professional Regulation.
Complete Sections I and VII.
Submit the $25 fee. Make check payable to the Florida
Request Duplicate License
Department of Business and Professional Regulation.
Complete Sections I, IV and VII.
Individuals must submit documentation supporting name
change. See Section IV of Instructions.
Name Change with Issuance of an
Submit the $25 fee. Make check payable to the Florida
Updated License
Department of Business and Professional Regulation.
Complete Sections I, VI and VII.
Submit the $155 fee. Make check payable to the Florida
Renewal Request
Department of Business and Professional Regulation.
 Complete Sections I, V and VII of this form.
 Pay $50 fee if not within renewal period (make check
Set License to Inactive
payable to the Department of Business and Professional
Regulation).
 Complete Sections I, V and VII of this form.
 Pay $50 fee (make check payable to the Department of
Set License to Active
Business and Professional Regulation).
Please mail your completed application, documentation and required fee(s) to:
Department of Business and Professional Regulation
2601 Blair Stone Road
Tallahassee, FL 32399-0783
Instructions
If you have any questions or need assistance in completing this application, please contact the
Department of Business and Professional Regulation, Customer Contact Center, at 850.487.1395.
Application Instructions
a. Section I - Transaction Type
i.
Check only the applicable transaction(s) you are seeking.
b
.
Section II – Close Business
i.
This transaction allows a business to reflect the closed status with the Department.
ii.
The section must be completed by the authorized representative. Mail the completed
application to the address at the top of the form.
iii.
There is no fee for this transaction; however, you must send your license back to the
Department with this form.
c. Section III – Address Change
i.
This transaction allows a business or individual to change their current mailing and/or
physical address.
DBPR AU-4154– Maintenance Form/Status Change
Eff. date: 07/10/2012
Incorporated by Rule: 61-35.005
ii. Choosing this transaction will change the address on file with the Department but it will
not issue an updated license with the new address information. If you wish to have an
updated license issued, you must pay a $25 fee and check the correct transaction type in
Section I.
iii. There is no fee for an address change without issuance of an updated license.
d. Section IV – Name Change
i.
This transaction allows a Business or Individual to change their registered name with the
Department of Business and Professional Regulation.
ii.
For a Business Name Change: Prior to applying for a name change with the Department,
the name change must be registered with the Florida Department of State, Division of
Corporations.
iii.
For an Individual Name Change: A change of name requires submitting supporting legal
documentation of name change (e.g. marriage license, court documents showing name
change, divorce decree, etc).
iv.
A new license will be mailed out to the current mailing address of record. Allow 10-15
business days for the new license to arrive once the request has been completed.
v.
The fee for this transaction is $25.00
e. Section V – Set to Active / Inactive
i.
Set to Active: This transaction is used to request that the license be reactivated outside
the renewal cycle. The license has already been renewed in an “inactive” status but now
the license wishes to place their license in an “active” status.
ii.
Set to Inactive: This transaction is used to request that the license be put in “inactive”
status outside the renewal cycle. A license can not be placed from “inactive” to “active”
and then to “inactive” during one renewal cycle.
f. Section VI – Renewal Request
i.
This transaction allows the business or individual to renew their license should they fail to
receive a renewal notice or the notice has been lost.
ii.
Send your request with a check or money order payable to: Department of Business and
Professional Regulation (DBPR).
iii.
To avoid any late fees make sure the renewal is postmarked on or before the expiration
date of the license.
iv.
A late fee will be accessed to all renewals postmarked after the expiration date.
v.
The fee for this transaction is $155.00
g. Section VII - Affirmation by Written Declaration
i.
The applicant must read and sign the affirmation by written declaration.
ii.
If the applicant fails to sign the affirmation statement, the Department will not process the
application.
DBPR AU-4154– Maintenance Form/Status Change
Eff. date: 07/10/2012
Incorporated by Rule: 61-35.005
State of Florida
Department of Business and Professional Regulation
Board of Auctioneers
Maintenance Form/Status Change
Form # DBPR AU-4154
Section I – Transaction Types
CHECK ONLY ONE OF THE APPLICATION TYPES
(Multiple transactions can be completed on this form)
[xxxx]
(Complete Sections I, II and VII)
Close Business
[9006]
(Complete Sections I, III and VII)
Address Change
[8001]
(Complete Sections I, III and VII)
Address Change with Issuance of Updated License -
[8001]
(Complete Sections I and VII)
Request Duplicate License –
[8001]
(Complete Sections I, IV, and VII)
Name Change with Issuance of Updated License –
(
[2020]
Complete Sections I, VI and VII)
Renewal Request ––
[4020]
(Complete Sections I, V and VII)
Set License to Inactive –
Set License to Active from Inactive –
3020]
(Complete Sections I, V and VII) [
APPLICATION TYPE
Individual
Business
License Number:
License Number:
CONTACT INFORMATION
Name:
Phone Number: (
)
-
Email Address:
Section II – Close Business
BUSINESS INFORMATION
Name of Business:
Section III – Address Change
NEW PHYSICAL ADDRESS
Street Address
City
State
Zip Code (+4 optional)
County (if Florida address)
Country
NEW MAILING ADDRESS
Street Address
City
State
Zip Code (+4 optional)
County (if Florida address)
Country
DBPR AU-4154– Maintenance Form/Status Change
Eff. date: 07/10/2012
Incorporated by Rule: 61-35.005
Section IV –Name Change
NAME CHANGE INFORMATION
If this transaction is for changing the company’s name, entities registered with the Department of
State/Division of Corporations must change their name there prior to making this request.
If this transaction is for changing a personal name, the individual must submit supporting legal
documentation of the name change with this completed form (e.g. marriage license, court documents
showing name change, divorce decree, etc).
Company/Individual Name (previous)
Company/Individual Name (new)
Section V – Set License to Inactive/Active (This only applies to the individual license only)
LICENSEE INFORMATION
Set License to:
 Active
 Inactive
Section VI –Renewal Request
If this transaction is for renewing a Company license, entities registered with the Department of
State/Division of Corporations must have a valid registration with them in order to be renewed.
License Number:
License Name:
Section VII – Affirmation By Written Declaration
AFFIRMATION BY WRITTEN DECLARATION
I certify that I am empowered to execute this application as required by Section 559.79, Florida Statutes. I
understand that my signature on this written declaration has the same legal effect as an oath or
affirmation. Under penalties of perjury, I declare that I have read the foregoing application and the facts
stated in it are true. I understand that falsification of any material information on this application
may result in criminal penalty or administrative action, including a fine, suspension or revocation
of the license.
Signature:
Date:
Print Name:
DBPR AU-4154– Maintenance Form/Status Change
Eff. date: 07/10/2012
Incorporated by Rule: 61-35.005
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