HR - Change of Legal Name

Please use this form to notify HR of legal name change.

1New Address or Phone > 2 > 3Review Your Entry
Please provide the new information in the applicable fields below.
Effective Date of Change: Effective Date of Change: / MM / DD YYYY

Please provide the date that this information should become effective.
Employee Name Employee Name First Last
Employee ID# (OneCard)
Must be 7 characters. Currently Entered: 0 characters.
Please use leading zeros if ID is fewer than 7 digits.
Submitter Email Address
What do you need to change?

What do you need to change? Name
New Full Name:
Preferred First Name (for Valpo Email):
Proof of Legal Name Change

Driver's License or Social Security Card
Upload a File
Save my progress and resume later
Enter Your Email Address *

A special link to resume the form will be sent to your email address.