Partner Account Name and/or Address Change Request Form
Name and/or Address change request forms can be submitted for a company's request to modify their legal business name or address listed in Broadcom database. 

All requests must be submitted with proper documentation showing Company Account Name or Address Change. Please note that incomplete submissions cannot be completed and will be rejected. 
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Email *
Partner Company Name  *
Current Partner Company Name
Broadcom Partner ID *
Your Name *
Is this a Name Change or Address Change Request? *
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