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Name Change Request Form

  1. Name Change Request Form

  2. To request Human Resources and Payroll update your name to match your legal name after a name change, please submit the following information. Employees will also need to submit the following to Human Resources: Copy of social security card with new name Completed State A-4 Completed Federal W4

  3. Submit the following to Human Resources:

    Copy of your new social security card

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  5. This field is not part of the form submission.