Facility Address Change Form

Note that if a facility is moving to a new location, its current certificate will expire and it will have to register as a new facility with a new WRAP ID.

If a facility is undergoing a government-initiated address change (an address change required by a local government that does not involve relocation), they will be issued a new certificate upon approval.

WRAP Facility Relocation / Address Change

Facility Name on Current Certificate(Required)

Facility's WRAP ID(Required)

Is your facility currently certified?(Required)

Yes

Reason for address change (choose one)(Required)

Facility moving to new location

Government-initiated address change

Current Facility Address(Required)

Street Address Address Line 2 City State / Province ZIP / Postal Code Country

Contact Name(Required)

First Last

Title

Phone(Required)

Email(Required)

New Facility Address(Required)

Street Address Address Line 2 City State / Province ZIP / Postal Code Country

Upload valid business license, reflecting the new address(Required)

Max. file size: 50 MB.

Confirmation(Required)

Confirm

I confirm the information above is accurate and I am authorized to submit on behalf of the facility.

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Phone

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