Penn State - Human Resources
Policy HR66 CHANGE OF LEGAL NAME OF AN EMPLOYEE
POLICY'S INITIAL DATE: November 15, 1968
THIS VERSION EFFECTIVE:
September 14, 1983
To notify appropriate University departments of an employee's change of
FORMS THAT MUST BE COMPLETED:
For an employee to change his or her name, it is necessary to obtain and
complete the following forms:
for Change of Beneficiary and/or Change of Name (Group Insurance).
for Purchase of U. S. Savings Bonds (when applicable).
Withholding Allowance Certificate (Form W-4).
- Approval Authorization Cards (when
applicable). (See instructions)
- Parking Registration Form (form available from Parking
Directory Adjunct Listing Information Form.
- Payroll Change Forms. (IBIS form - see
FORMS THAT MAY BE COMPLETED AT THE OPTION OF THE
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
OHR-Hershey, replenished by OHR-Univ Park
Erie-The Behrend College & Harrisburg: Dir of Business Serv,
replenished by OHR Employee Benefits Div.
- Nomination of Beneficiaries (State Retirement).
Office of Human Resources - Employee Benefits Division, 865-1473. (see