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
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