The Name Change Request Form is the form the Cosmetology Commission of the South Dakota Department of Labor & Regulation uses to update the name on a cosmetology license. Licensees whose name has changed, for example through marriage or a court order, send it with a copy of the supporting document and payment. On this page you can fill out the name change request form online on FillingPDF and download or print the completed PDF. The Commission publishes the official PDF at dlr.sd.gov.
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What is Name Change Request Form – South Dakota?
The Name Change Request Form is the South Dakota Cosmetology Commission form on which a licensee asks to have a license reissued under an updated name. The Commission is part of the South Dakota Department of Labor & Regulation.
The form is short. It asks for your current name (First/Middle/Last), your personal license number, the name you want to change to (First/Middle/Last) and the supporting document or documents you are including. It ends with the licensee's signature and the date.
Completing it produces a request, not a license. The Cosmetology Commission reissues your license or licenses with the updated name and mails them to the address it has on file for you. The form states that a license replacement fee applies per license, pursuant to ARSD 20:42:03:03, and that payment is made by check or money order for all applicable licenses you currently hold.
The revision printed on the form is Rev. 07/2025. The Commission's forms page lists other documents, such as the Instructor License Application and the License Certification Request Form for licensees transferring a license to another state; this form is only for changing the name on a license you already hold.
Who needs to file Name Change Request Form – South Dakota?
Licensees of the South Dakota Cosmetology Commission whose legal name has changed and who want their license or licenses reissued with the new name use this form. The form identifies you by your personal license number, so it is meant for people who already hold a license.
If you hold more than one license, the form says to include payment for all applicable licenses you currently hold, so the request covers each of them.
The supporting documents named on the form as examples are a marriage certificate and a court order. The form gives these as examples ("e.g."), so other documents that show the name change may also be included in the Supporting Document(s) line.
The form has a single signature line for the licensee. It does not describe anyone signing on a licensee's behalf. If you need help completing it, the form says to call the Cosmetology Commission at 605.773.6193.
When to file Name Change Request Form – South Dakota
Send the form once your name has changed and you have the document that proves it, such as a marriage certificate or court order. The form prints no deadline, so it is not tied to a due date. The Commission reissues your license with the updated name after it receives the request, the supporting document copy and the payment. The form states no processing time. Because the reissued license is mailed to the address the Commission has on file for you, check with the Commission at 605.773.6193 if you have questions about that address.
Documents you need
- A copy of the supporting document or documents for the name change, such as a marriage certificate or court order, listed on line 4.
- Payment by check or money order for the license replacement fee, for all applicable licenses you currently hold. Contact the Commission for the amount.
How to fill out Name Change Request Form – South Dakota
Enter your current name
On line 1, Current Name, write your name as First/Middle/Last exactly as it appears on your license.
Enter your license number
On line 2, Personal License Number, enter your personal license number. If you hold more than one license, plan to pay for each one.
Enter the name you want
On line 3, Change my name to, write the new name as First/Middle/Last.
List your supporting documents
On line 4, Supporting Document(s) included, name the document you attach, such as a marriage certificate or court order.
Sign and date the form
Sign on the Licensee Signature line and enter the date next to it.
Prepare your payment
Get a check or money order for the license replacement fee for each applicable license you currently hold. Ask the Commission at 605.773.6193 for the current amount.
Review and download the completed PDF
Check that both names, the license number and the signature are correct. Download or print the completed PDF from FillingPDF, then assemble the package with your supporting document copy and payment as described under How to submit.
How to submit Name Change Request Form – South Dakota
The form names one channel: mail to the Cosmetology Commission.
- By mail: send the completed form, a copy of the supporting document or documents and your payment to the Cosmetology Commission, 217 W. Missouri Ave., Pierre, SD, 57501.
- Payment: include a check or money order for the license replacement fee for each applicable license you currently hold. The form cites ARSD 20:42:03:03 and does not change by license; contact the Commission for the current amount.
- Questions: call the Cosmetology Commission at 605.773.6193 if you need help completing the form.
The Commission reissues the license with your updated name and mails it to the address it has on file for you. FillingPDF lets you fill out and download the PDF; submission follows the channels above.
Common mistakes to avoid
- Mailing the form without a copy of the supporting document, such as a marriage certificate or court order, that proves the name change.
- Leaving out payment; the form asks for a check or money order for all applicable licenses you currently hold.
- Paying for only one license when you hold several, since the replacement fee applies per license.
- Leaving line 4, Supporting Document(s) included, blank instead of naming the documents you attach.
- Entering names without following the First/Middle/Last order shown on lines 1 and 3.
- Submitting the form without the licensee signature and date.
- Handwriting the form illegibly; the instructions ask you to legibly print the information if you do not fill it out online.
- Sending the request to an address other than 217 W. Missouri Ave., Pierre, SD, 57501.
Frequently asked questions
What is the name change request form for a South Dakota cosmetology license?
It is the Cosmetology Commission's Name Change Request Form. You use it to ask the Commission to reissue your license with your updated name. It asks for your current name, license number, new name and the supporting documents you include.
What do I attach to the Name Change Request Form?
Attach a copy of the supporting document or documents for the name change, such as a marriage certificate or court order. Also include payment by check or money order for all applicable licenses you currently hold.
Is there a fee to change the name on my license?
Yes. The form states a license replacement fee per license, pursuant to ARSD 20:42:03:03, payable by check or money order. The amount is not repeated here; call the Cosmetology Commission at 605.773.6193 to confirm it.
Where do I send the Name Change Request Form?
Mail it to the Cosmetology Commission, 217 W. Missouri Ave., Pierre, SD, 57501, with the supporting document copy and your payment. The form names no other submission channel.
Can I fill out the name change request form online?
Yes. You can fill out the PDF online on FillingPDF and download or print it. FillingPDF does not send it to the Commission; you mail it yourself. The form also allows printing it and completing it by hand.
Where will my new license be mailed?
The Cosmetology Commission reissues your license or licenses with the updated name and mails them to the address it has on file for you.
Who can I call for help with the form?
Call the Cosmetology Commission at 605.773.6193. The form lists that number for help completing it.
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