Fillable TIAA-CREFNoticeofChangeofName F82_Notice_Name Change_Form_05

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TIAA-CREFNoticeofChangeofName F82_Notice_Name Change_Form_05

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File type: PDF

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CHANGE OF NAME
TIAA Annuity Number CREF Annuity Number TIAA Policy Number
Social Security Number
Former Name
Title First Name Middle Name
Last Name
Former Signature
New Name
My Name has been changed to that given below and I authorize you to use the new name hereafter:
Title First Name Middle Name
Last Name
New Signature
Address
City State Zip Code
CONTINUED ON NEXT PAGE
Please print in capital
letters and only use
black or dark blue ink.
Return this form to:
TIAA-CREF
P.O. Box 1264
Charlotte, NC 28201
NOTE: This form and
certified documentation
will only be accepted
by mail. It cannot be
accepted via fax.
Please sign in black or
dark blue ink.
Please sign in black or
dark blue ink.
TA_MN
F82 (2/10)
NOTICE OF CHANGE OF NAME
My Name has been changed by: (Check appropriate box below)
Marriage* Divorce* Adoption* Court Order* Other*
If other, please explain
Date of Name Change (mm/dd/yyyy)
Court Name
Court Address
City State Zip Code
For TIAA-CREF USE ONLY
Accepted — Teachers Insurance and Annuity Association College Retirement Equities Fund
*Note: A certified copy
of any Court Order
or other document
authorizing the change
must be furnished.
NOTE: This form and
certified documentation
will only be accepted
by mail. It cannot be
accepted via fax.
NOTICE OF CHANGE OF NAME
TA_MN
F82 (2/10)
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TIAA-CREFNoticeofChangeofName F82_Notice_Name Change_Form_05

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Completed 20 February 2020

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