MARYLAND BOARD OF MORTICIANS AND FUNERAL DIRECTORS

ESTABLISHMENT NAME CHANGE FORM



(Requirements per Health Occupations 7-310 and COMAR 10.29.03.03(H)(2), 10.29.03.04(8)(f), 10.29.04)


Please submit the completed Establishment Name Change form, a copy of the Maryland State Department of Assessments & Taxation (SDAT) verification, and the payment receipt.


Establishment Name Change Form

DOWNLOAD FORM HERE:

https://health.maryland.gov/bom/Documents/estabname.pdf

Establishment Name Change Fee: $150.00

PAY HERE:

https://mdbnc.health.maryland.gov/mort_pay/Pay_Fee_Estab_NameChg.aspx

  1. Completed & Signed Establishment Name Change Form
  2. A copy of the Maryland State Department of Assessments & Taxation (SDAT) verification
  3. There is non-refundable Establishment Name Change Fee of $150.00. PAY HERE: Establishment Name Change Fee
  4. Upload a copy of your receipt to the box below.
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