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Notice of Member Name Change

(For use with associations, clubs, and other membership organizations)

Organization Name _____________________________________

Address _____________________________________________

City _____________________ State ________ Zip Code_______

Please be advised that the following member has changed their name.

Current name on record ___________________________________

Member # ______________________________________________

Please change the current name on record to reflect the member's new married name.

New Name ______________________________________________

Address ______________________________________________

City _____________________ State ________ Zip Code________

(Check all that apply)

___ The above also reflects a change of address.

___ Forward a Designation of Beneficiary Form. (If survivor benefits available)

Please make the above referenced change of record. If you have any further questions regarding this matter please call me at: ___________________ (phone number)

Ver truly yours,

 

_____________________ ___________

(Sign name here) (Date)

_____________________

(Print name here)

 

Enclosure: Certificate of Marriage

(c) 2001, Douglas N. Smith, Esquire, All Rights Reserved -- Free New Bride Name Change Kit -- www.bridelaw.com