Alabama A&M University Name Change Procedure and Form
Office of Human Resources February 2016
Name Change Benefit Information Checklist
After changing your name, the below items may apply to you.
1. _____The employee may wish to change his/her email address. If so, send an email to Ted
Stewart in Information Technology System indicating the current name and the new name for
the email address.
2. ____ The employee may wish to change his/her federal and state tax status in cases where the
marriage status changed. The employee should complete a new form A-4 for Alabama tax
withholding and a new form W-4 for federal withholding. The forms are located on the Office
of Human Resources website and in the Office of Human Resources. After completing the
form, submit the tax form(s) to the Payroll Department, Patton Hall, room 105.
3. ____ The employee may wish to change his/her beneficiary information. To change the
beneficiary information for the life insurance, the Guardian Beneficiary Designation Change
(GG-17) form should be completed. The file is located in the Office of Human Resources or
at https://www.guardianlife.com/sites/default/files/gg-17beneficiarychangeform.pdf
4. ______To change the beneficiary information for the Teachers’ Retirement System, the
Change of Beneficiary (RSA Form 100C) form should be completed. The file is located in
the Office of Human Resources or at http://www.rsa-al.gov/uploads/files/RSA_100-
C_Change_of_Beneficiary.pdf
5. ____ If the employee has a voluntary retirement plan (TIAA-CREF, LSW, VALIC or
ASPRIE), the employee should contact Mr. Wilbert Hamilton at 256.541.4565 for name change
and if applicable change beneficiary information.
6. _____ To change the name with Teachers’ Retirement System of Alabama and PEEHIP health
insurance, the employee must provide a copy of his/her social security card to TRS and
PEEHIP. The change will automatically transmit to Blue Cross Blue Shield of Alabama and
member will receive a new insurance card. Mail the documents to TRS, P.O. Box 302150,
Montgomery, AL 36130-2150.
7. ____ To change the name with Guardian and Aflac, the _Guardian Enrollment Application
and AFLAC Request for Name Change (Form H-L0046.12A)__form should be completed.
The form is located at https://www.aflac.com/docs/employers/change-forms/aflac-name-
change-form.pdf
8. ____ To change the beneficiary with Aflac, the _Request for Beneficiary Change (Form H-
L0046.12C)_form should be completed. The form is located at
https://www.aflac.com/docs/employers/change-forms/aflac-beneficiary-change-form.pdf