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 AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest 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
