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Employee Information Change

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Commonwealth of Massachusetts
Human Resource Division

Requester Information

Select one or more items to change.

Name Change

New Name


Select to Upload Name Change Documentation...
Select to Upload Identification Card...


Home Address
Mailing Address
(Leave mailing address blank if same as home address)


Provide other phone number and type if not listed above

E-mail Address

Emergency Contact

Secondary (optional)

Smoking Status


Marital Status

Divorce Decree required
Marriage Certificate required

Birth Date

Changes to Date of Birth require a copy of your birth certificate or government issued identification card


Select to Upload Birth Certificate...
Select to Upload Identification Card...

Highest Education Level

Changes require a copy of your transcript

Military Status

Changes require form DD 214 or ODEO certification for Vietnam Era Veteran status