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Change of Name / Change of Address Form

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Change of Name

Please Note: You must submit legal documentation (i.e. a copy of an updated Driver's License, Social Security Card, Marriage Certificate, etc.) with a request for a name change. Please send the legal documentation form to Payroll at District Office ( Your change of name will not officially take place until this documentation is submitted.
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Would you like your Comsewogue Email Address to be updated to reflect your new name? *

Change of Address

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Employee Signature

I confirm that all of the information above is correct. *