Instructions for Completion:
1. Check the appropriate box to indicate type of change.
2. Include customer name and FEI/Employee ID on all requests.
3. Use the ‘Comments’ section for other changes not identified on this form or for additional information.
4. Include name and phone number of person submitting request.
5. If the request is to change the customer name, follow up form submission by faxing ONLY the supporting documentation to (404) 463-5089. Please include a fax cover sheet. Acceptable documentation would be a letter from the customer, copies of the legal name change papers from the Secretary of State’s office, or a new W-9 completed by the customer.