Change in Personal Information for MCPS Employees

INSTRUCTIONS: Please type or print.  MCPS current employees should this form to change or correct your date of birth, gender, and/or Social Security number (only after receipt of your new official Social Security card). Changes to name, title, home address, telephone number, and/or email changes must be made via Hub+.

Complete this form, sign, and return it to the Employee and Retiree Service Center (ERSC). You may fax the form to 301-279-3642/301-279-3651 or email an electronically signed Adobe PDF file to ERSC@mcpsmd.org.

NOTES

1. You must complete ALL sections in the first box.
2. To change your address and/or telephone number on record with MCPS, you must visit Hub+ and complete the online form.
3. You must go (in person) to your local Social Security Administration Office to complete the required form to change your Social Security records. Requested name changes will only be processed as they appear on your Social Security card.
4. You must complete a new W-4 if you change your marital status and/or number of exemptions for income tax withholding purposes. All W-4 changes are made online via HUB+. To access the online form, visit HUB+ and select the Me tab. Next, click on the Direct Deposit & W-4 tile and then on Tax Withholding. Click on the editing tool to update the form as needed..
5. This form does not change your name on record with the Maryland State Retirement Agency, Educational Services Federal Credit Union, retirement savings, etc.

Change in Personal Information for MCPS Employees

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