EPN Program employer account changes
To view a list of frequently asked questions and answers provided by the California EPN authority, click California EPN FAQ .
How to Update Contact Information on Employer Pull Notice Account
Form Needed
Steps to Follow
If an employer needs to update/change its account information on file with the EPN Program office, it should do the following:
- Complete Form INF 4
- After completing the above form, please forward the form via the options below.
- Via Mail to the below address:
Verisk/Insurance Information Exchange
Attn: Government Relations
1574 Crescent Pointe Parkway
College Station, TX 77845
- Via email to iiXGovRelations@iso.com
*** This includes all information EXCEPT name/dba changes. All name changes must have the original copies with the "wet" signature. Forms with that change MUST be forwarded via mail/FedEx.***
Once the form is received, Verisk will forward the form to the EPN Program office for processing.
This is to be used when any changes occur to the company name, address, phone number or contact person.
The INF 4 must be submitted by the employer within 10 days of the change.