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TRS Name Change Form

 

Handle: Document-81242
Owner: Fuller, Tina (User-7387, tfuller:DocuShare)DS
Monday, March 19, 2012 09:40:51 AM EDT
Wednesday, October 23, 2013 09:11:31 AM EDT
Modified By: Dickenson, Rhonda (User-8396, rhonda.dickenson:gvwfl)DS
Locked By:
  • GRE-50 (3/10)
NEW YORK STATE TEACHERS’ RETIREMENT SYSTEM 10 Corporate Woods Drive, Albany, NY 12211-2395 MEMBER NAME/ADDRESS CHANGE If you have changed your name, please indicate former name below.
  • OFFICE SERVICES ONLY
SIGNATURE INSTRUCTIONS: To change your name or address, please complete this form and return it to the System.
  • First Name
MI Last Name PO Box, Apt.
  • If you recently remarried or divorced, review your NYSTRS beneficiary designation, as you may need
to update it.
Allowed
Adobe Portable Document Format (.pdf) - application/pdf
TRS Name Change.pdf
No
4
105530
No
Appears In: Payroll Dept.
Preferred Version: TRS Name Change Form