Quality Assurance Division
Child Care Licensing
Change of Name/Address/Ages Application
The following forms/information are included in an Address Change Application for Family, Group, and Center Facilities:
- Name/Address/Ages Change Checklist (Print First)
- Name/Address/Ages Change Application
- W-9
- Fire Safety Record and Evacuation Plan
- Insurance Verification Form
- Floor Plan/Square Footage Report
All Change of Name/Address/Ages Application Packets should be submitted to the Child Care Licensor for your County:
A list of the Child Care Licensors by county may be obtained from http://www.dphhs.mt.gov/contactus/childcarelicensing.shtml.
