Change of Employer Or Other Information Notification

1300 SUMNER AVENUE CLEVELAND, OHIO 44115-2180 Telephone: 216- 241-733 Fax: 216-241-0105 E-Mail: [email protected]

AAADM CERTIFIED INSPECTOR CHANGE OF EMPLOYER OR OTHER INFORMATION NOTIFICATION

Inspectors must notify AAADM when a change of employment, address, telephone or e-mail address occurs and must provide AAADM with updated information. Please note that the inspector diploma need not be altered in any way when there is a change in employment. Upon request, a new company certificate will be issued for $10.00 verifying the inspector is now an employee and is a certified inspector on staff. Payment can be made via check or at www.aaadm.com/paypal/certification.htm. Changes to the “Find a Certified Inspector” list are made quarterly.

PLEASE PROVIDE UPDATED INFORMATION :

Do you want a new company certificate? Yes No

Inspector Number: Inspector Name:

Home Address: [Street Address, not P. O. Box] City, State, Postal Code:

Previous Employer: New Employer:

Business Address: [Street Address, not P. O. Box] City, State, Postal Code: Telephone Number: Facsimile Number: E-Mail Address:

______Date Inspector Signature

PLEASE COMPLETE THIS FORM AND RETURN IT TO THE AAADM OFFICE VIA E-MAIL

06/2015