Step 1) Please complete the following required information.

Your name:

Date of Birth (mm/dd/yy):

Email Address:

Last 4 digits of your SSN:

Step 2) Please complete the following required information about your NEW address.

Address Line 1:

Address Line 2:

City:

State: -- Please Select Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming

Zip:

Country:

Home phone:

Work phone:

Step 3) Please complete the following information about your PREVIOUS address.

Address Line 1:

Address Line 2:

City:

State: -- Please Select Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming

Zip:

Country:

Home phone:

Step 4) Clicking the button below will submit your request for a Change of Address with the SLSC. Be sure that you have completed all required fields above. Thank you.