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Universal Name/Address Change Form A copy of a Social Security card is required for a name change. PRINT OR TYPE USE BLACK INK. Type of subscriber (check one): Active Retired COBRA Survivor PBA Insurance
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SOCIAL SECURITY # of COBRA Number 3. SOCIAL SECURITY # of PBA Number 4. SOCIAL SECURITY # of Insurance Benefit Number 5. SOCIAL SECURITY # of Social Security Card. Type of Mailing Address This form must be mailed directly to Social Security at P.O. Box 75014, Kansas City, MO 644. NOTE: If you want to use this form to change your Social Security number, mailing address must match the Social Security Administration (SSA) identification number. Name Change Instructions If you are applying for a new Social Security Number or change your Social Security number after being retired and are a dependent of an active participant, you may apply to change your name and sex. If you have never applied to change your name or identity, please begin here to complete this form. You must complete the following steps if you are asking to change the sex on your SSN or to apply to change your gender designation on your Social Security card. Step 1: Fill in all the required information. Complete any gaps and complete the entire information. Step 2: On the back of the form, you must tell us if you want to change your sex designation on your Social Security card. NOTE: If you already have a current sex change on your card, you will need to complete step 2. Step 3: On the front of the form, you must write the Social Security office or Social Security office of the beneficiary where you live and state to why they should give you a social security number with an updated sex designation. Step 4: On the back of the form, write your last name, date of birth, and SSN. On the front of the form, write your Social Security number. On the back of the form, write your name and signature. Social Security Administration (SSA): SSA's Privacy Officer: If you have a question you do not see covered above, please contact SSA at. Mail-In Requesting a Social Security Number You can also request a Social Security Number or use the mail to apply. To mail your request, you may submit your request electronically, or you may bring it in person to the SSA office.

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EIP universal name change refers to the process of changing a person's name in the EIP (Entity Identification Plus) system. It allows individuals or entities to update their registered name within the EIP database.
Any individual or entity that needs to update their registered name in the EIP system is required to file an EIP universal name change request.
To fill out the EIP universal name change request, you need to provide the necessary details such as the current registered name, the desired new name, and any supporting documents required by the EIP system. The request can typically be submitted online through the EIP portal or through a designated form.
The purpose of EIP universal name change is to ensure accurate and up-to-date information within the EIP system. It allows individuals or entities to reflect any legal name changes, mergers, acquisitions, or other relevant updates.
The information that must be reported on an EIP universal name change includes the current registered name, the desired new name, and any supporting documentation as required by the EIP system. Additional details such as the reason for the name change may also be required.
The deadline to file an EIP universal name change in 2023 depends on the specific regulations and guidelines set by the EIP governing body. It is recommended to refer to the official documentation or contact the EIP administrator for the exact deadline.
The penalty for the late filing of an EIP universal name change may vary depending on the regulations and policies set by the EIP governing body. It is advised to consult the official documentation or contact the EIP administrator to determine the specific penalties or consequences for late filing.
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