REQUEST CHANGE OF ADDRESS

If you didn't receive or lost your printed W-2, please complete the W-2 Reprint Request.

This form is for former employees (For eg: terminated, retired, retired with pay) who no longer have access to CIS to request change to Home Address. If you are a current employee, please log in to CIS and update your address

*please allow 2-3 business days for processing*

Name:
uNID (if known):
Email Address:
Date of Birth:	(Format mm/dd/yyyy)
Last 4 digits of SSN:
New Address:
By checking this box, I hereby acknowledge that I have legal authority to request this data update.

campus:

REQUEST CHANGE OF ADDRESS