Get the free Member Change of Address Form (PRS 221). Member Change of Address Form (PRS 221)

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Participant Information Participant s Full Name Social Security Number or CalPERS ID Change Requested Update my address for mailing my checks or direct deposit slip Change my physical address Change my address for mailing other information Please fill in your correct mailing address. Reports to CalPERS and other state agencies 5. Coordination of benefits among carriers 6. Resolving member appeals complaints or grievances with health plan carriers Information Disclosure Portions of this...

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How to fill out member change of address

01

Step 1: Obtain the member change of address form from the official website or office of the organization.

02

Step 2: Fill in your personal information such as name, current address, and contact details in the designated fields of the form.

03

Step 3: Provide your previous address and the effective date of the address change.

04

Step 4: Make sure to sign and date the form.

05

Step 5: Submit the completed form to the appropriate department or office of the organization. You may need to attach supporting documents such as proof of new address or identification.

06

Step 6: Wait for confirmation or acknowledgment of the change of address from the organization.

Who needs member change of address?

01

Members of an organization or institution who have moved to a new address need the member change of address form. This could include individuals who have changed their residence, office, or any other location associated with their membership. The form is typically required to update the organization's records and ensure effective communication and delivery of relevant materials.

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What is member change of address?

Member change of address is a process of updating a member's address information in the records.

Who is required to file member change of address?

The member themselves or their authorized representative is required to file the change of address.

How to fill out member change of address?

The member can fill out the change of address form provided by the relevant organization or company, and submit it with the necessary documentation.

What is the purpose of member change of address?

The purpose of member change of address is to ensure that the member's address information is up to date for communication and documentation purposes.

What information must be reported on member change of address?

The member must report their old address, new address, effective date of change, and any other relevant information requested.

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