Division of Rehabilitation and Liquidation
Claimant's Change of Name/Address Forms
If you are a claimant or policyholder of a company in liquidation and you have
recently moved or otherwise changed your current name and/or mailing address, you will need to download and complete the
appropriate form
in order for the Division of Rehabilitation and Liquidation to update our
records. Once you have downloaded the appropriate form, you will need to complete all
applicable sections, attach any supporting documentation and then return it to the mailing address
listed below.
 The forms are provided as Adobe Acrobat PDF files and require
the free Adobe Acrobat reader software (
download software - you are leaving the DFS website and
opening a new browser window)
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