ALDOI - Name Change Request Invoice

Name Change Request

Below is your invoice for requesting a name change. Note that according to Section 27-7-17(B), Code of Alabama 1975, a licensee is required to notify the Department of Insurance of a legal change in name within 30 days of that change. Failure to comply with this statute will result in a $50 penalty.

ALL FEES ARE NONREFUNDABLE.

Transaction Number:

License Number:

Effective Date:

Invoice Date:

6/27/2024

Credit card - 3% of total due + $2; ECheck - $4

Select Payment Type:

Credit Card

ECheck

Penalty Fee:

$50.00

Processing Fee - Alabama Interactive:

Total Amount Due:

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