Change of Address/Name Notification Name on License * Gaming License # * License Type - None -SupportKeyOther Phone Number E-mail Address * ADDRESS CHANGE New Street Address City State Zip Code County Mailing Address (if different from street address) City State Zip Code County NAME CHANGE New Name Reason for Name Change (select ONE): Marriage (please enter date): Divorce (please enter date): Court Order (please enter date): Submit a copy of the legal documentation reflecting the name change. Acceptable forms of documentation include: marriage license, divorce decree, court order, immigration records, or passport. E-mail documentation to Paul Hernandez at paul.m.hernandez@state.co.us, or fax to (303) 205-1308. Tweet