CHANGE OF CANDIDATE INFORMATION RECORD

CHANGE OF CANDIDATE INFORMATION RECORD

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PLEASE “X” INFORMATION BELOW—IF MARKED, ADDRESS AND PHONE NUMBER(S) WILL APPEAR IN THE CERTIFICATION ROSTER, LISTED ON OUR WEBSITE:

By signing and submitting this form, I confirm that all of the information provided is accurate and true. I authorize the International Code Council to update my information and list any indicated information on the Code Council website.