No. Enter the Social Security Number that is currently on file for the employee. Last Name Enter the last name that is currently on file for the employee. First Name Enter the first name that is currently on file for the employee. If there are changes being made to administrative data, the Effective Date and Action Code fields MUST be completed. Once this information is entered, complete ONLY the administrative data that is being changed.
Effective Date Enter the date on which the change in administrative data is effective.
Enter the four-position code to identify the reason why the change in administrative data is being made to the employee's record. Codes are listed on the reverse side of the change form . Ensure that it is the same number entered on the Employee's W-4 Form. Last Name Enter the employee's changed last name. If the employee has multiple Research Foundation appointments and more than one title, enter the employees changed primary title code.