Form SPS13-11 "Notification to Change Licensee Form" - Georgia (United States)

What Is Form SPS13-11?

This is a legal form that was released by the Georgia Department of Agriculture - a government authority operating within Georgia (United States). As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on September 2, 2014;
  • The latest edition provided by the Georgia Department of Agriculture;
  • 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 printable version of Form SPS13-11 by clicking the link below or browse more documents and templates provided by the Georgia Department of Agriculture.

ADVERTISEMENT
ADVERTISEMENT

Download Form SPS13-11 "Notification to Change Licensee Form" - Georgia (United States)

Download PDF

Fill PDF online

Rate (4.6 / 5) 87 votes
Structural Pest Section
19 Martin Luther King, Jr. Dr.
Atlanta, Georgia 30334-4201
Phone: (404) 656-3641
NOTIFICATION TO CHANGE LICENSEE FORM
Use when the status of a company changes, for example, when the company or accounts are sold or the
company is no longer operating in the business of Structural Pest Control.
Company License Number ______________________ Date___________________________
Company Name______________________________________________________________
Which describes the situation (check which applies):
____The company is no longer in business – close of business date :___________________
OR
____The company and/or accounts have been sold to a new owner/Licensee.
Company Name_____________________________ License Number ______________
Owner/Licensee Name_____________________________________________________
Submitted and Signed by _______________________________________________________
E-mail address: ______________________________________________________________
Submit this form by mail, fax or e-mail (
pest@agr.georgia.gov
)
Additional Remarks:
In accordance to Chapter 620-3.02(8)(g), the licensee shall notify the Department in writing, within ten days of any change of address
or closing of any office.
SPS 13-11 Revised 9/2/14
Structural Pest Section
19 Martin Luther King, Jr. Dr.
Atlanta, Georgia 30334-4201
Phone: (404) 656-3641
NOTIFICATION TO CHANGE LICENSEE FORM
Use when the status of a company changes, for example, when the company or accounts are sold or the
company is no longer operating in the business of Structural Pest Control.
Company License Number ______________________ Date___________________________
Company Name______________________________________________________________
Which describes the situation (check which applies):
____The company is no longer in business – close of business date :___________________
OR
____The company and/or accounts have been sold to a new owner/Licensee.
Company Name_____________________________ License Number ______________
Owner/Licensee Name_____________________________________________________
Submitted and Signed by _______________________________________________________
E-mail address: ______________________________________________________________
Submit this form by mail, fax or e-mail (
pest@agr.georgia.gov
)
Additional Remarks:
In accordance to Chapter 620-3.02(8)(g), the licensee shall notify the Department in writing, within ten days of any change of address
or closing of any office.
SPS 13-11 Revised 9/2/14