Human Resources Policies
HR66 Change of Legal Name of an Employee
Policy Steward:Vice President for Human Resources>
POLICY'S INITIAL DATE: November 15, 1968
THIS VERSION EFFECTIVE: September 14, 1983
To notify appropriate University departments of an employee's change of name.
For an employee to change his or her name, it is necessary to obtain and complete the following forms:
- Request for Change of Beneficiary and/or Change of Name (Group Insurance).
- Employee's Withholding Allowance Certificate (Form W-4).
- Approval Authorization Cards (when applicable). (See instructions)
- Parking Registration Form (form available from Parking Chairpersons)
- Payroll Change Forms. (IBIS form - see instructions)
The following forms may be completed to initiate certain changes that the employee may desire due to a name change:
- Voluntary Group Accident Insurance Enrollment Form.
Univ Park: OHR-Employee Benefits Div, 865-1473
Hershey: OHR-Hershey, replenished by OHR-Univ Park
Commonwealth Campuses, Erie-The Behrend College & Harrisburg: Dir of Business Serv, replenished by OHR Employee Benefits Div.
- Nomination of Beneficiaries (State Retirement).
Available from Office of Human Resources - Employee Benefits Division, 865-1473. (see instructions)