General Inquiry

Select a TDLR program*

Are you requesting a change of information

Yes

If you are requesting a change of contact information please use the online form at
https://www.tdlr.texas.gov/ContactInfoUpdate/LicenseProgram.aspx

If yes, select type of change, if no, leave blank

Name Change**

Add/Correct my Social Security #**

Unable to change Contact Information Online

**NOTE: Attach a government issued ID, court document, marriage license, social security card, etc for changes other than contact information.

First name*

Last name*

Date of birth

Email address*

Phone number*

TDLR license number (if applicable)

Message*

Attachments (BMP, DOC, DOCX, GIF, JPEG, JPG, PDF, PNG, TIFF, XLS, XLSX)

Drop files here, or browse to attach files

Confirmation Required

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**Note: Max total upload size is 35MB. If your total attachment size is larger than 35MB, your email will not be received. You can submit additional files
by filling out this form again with the extra attachments.

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