What information does the form request?

It asks for the license number, owner, DBA name, business and home addresses and telephone numbers before and after the change, the effective date, and the owner’s signature and date.

Who uses the precious metal license change form?

An owner of a precious metal license can use it to report changes to business or home contact information associated with the license.

Do I need a notary for the Change of Information for Precious Metal License?

No. The owner signs and dates this document without a notary; no notarized or sworn attachment is identified.

Dutchess County, NY · Dutchess County

No notary required

Change of Information for Precious Metal License

Dutchess County precious metal license owners use this form to report changes to business or home contact information and the effective date.

At a glance

Issued by: City of Dutchess County · Dutchess County, Dutchess County, New York
Notarization: Not required: file this form without a notary.
Official source: dutchessny.gov
Blank form: Download the PDF
Catalogued: Oct 5, 2026
Machine-readable: JSON record · about the forms index

What this form is

This form records changes to information associated with a precious metal license. The owner can provide the license number and enter previous and updated DBA name, business and home addresses, and telephone numbers, along with the change’s effective date. The owner signs and dates the form.

Who needs it

Owners of a precious metal license can use this form when their business or home contact information changes.

How to submit it

Submit the completed form to Dutchess County Department of Health, Division of Weights and Measures, 98 Peach Road, Poughkeepsie, NY 12601.

About notarization

This document is signed without a notary; the owner signs and dates the change, and no notarized or sworn attachment is identified.

How to submit this form

1
Download the Form
Download the Change of Information for Precious Metal License form.
2
Complete the Change Details
Enter the license and owner information, previous and updated details, and the effective date.
3
Sign and Date
The owner signs and dates the form.
4
Submit to the County
Submit it to the Dutchess County Department of Health, Division of Weights and Measures, at the address on the form.

Frequently asked questions

What information does the form request?: It asks for the license number, owner, DBA name, business and home addresses and telephone numbers before and after the change, the effective date, and the owner’s signature and date.
Who uses the precious metal license change form?: An owner of a precious metal license can use it to report changes to business or home contact information associated with the license.
Do I need a notary for the Change of Information for Precious Metal License?: No. The owner signs and dates this document without a notary; no notarized or sworn attachment is identified.
How do I submit the Change of Information for Precious Metal License?: Submit the completed form to the Dutchess County Department of Health, Division of Weights and Measures, at 98 Peach Road, Poughkeepsie, NY 12601.

Need something notarized?

This Change of Information for Precious Metal License doesn’t need a notary, but if you have another Dutchess County form that does, a commissioned online notary can help.