Online Office Information Change Form IVAR Office Information Change Form Use this form to notify IVAR of changes in your Office contact information. Action Being Taken: (check all that apply)* New Manager New Broker Add New Office Add Branch Office Make a change to an Office Effective Date of Change* MM slash DD slash YYYY New Office Manager Name:New Broker Name:New Email: Enter Email Confirm Email New Office Name:New Website: New Office Telephone Number:New Office Fax Number:New Office Address: Street Address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code I agree that IVAR should update the information as stated above:* Yes No Name of Authorized Manager/Broker:*The email address of Authorized Manager/Broker:* Enter Email Confirm Email Δ
