Facilities Services Department
Notice of Address Change
Instructions: This form should be completed for Faculty/Staff moving from one office to another or one building
to another. This form will then be distributed to Shipping/Receiving and Mail Services to insure the efficient
delivery of items to the person or persons on the form. Send the form to facilityservices@durhamtech.edu
Employee Name: ___________________________________
Moving from: Department ____________________________
Moving to: Department ______________________________
Effective Date of Move: ______________
__________________________________________________
Employee Signature
__________________________________________________
Received by Signature
Date prepared: ______________
Office/Building:_____________________
Office/Building: _____________________
______________
Date
______________
Date
N
otes:
1) A copy of this form will be kept on file either in Shipping/Receiving or Mail Services.
2)
I
f more than one person or department is moving, please attach a spreadsheet with all the peopl
e
i
nvolved to this document
.
click to sign
signature
click to edit
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click to sign
signature
click to edit
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