Name Change

To submit a name change to KBN, complete the Name Change Form [PDF Format - 17 KB], and mail it along with the appropriate attachments to the Board address listed on the form.

Required attachments include:

• $35 processing fee
• Your current active license card
• Required legal documentation (includes a copy of any one of the following)
  • Certificate of Marriage
  • Divorce Decree Showing the Legal Authority for a Name Change
  • Court Order
  • Social Security Card

Requests for a name change may be submitted at anytime.  Upon receipt of the fee and required documentation, a new license card will be issued. 

For a current list of KBN fees, refer to Fees for Licensure and Registration Applications and Services [PDF Format - 18k].