Personal Data Change Form - Nordic
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1 Personal Data Change Form - Nordic Instructions: This form is used for employees to change personal data. Please ensure to complete Section A and only those fields where data will change. If the section requires supporting documentation, please attach a copy of a valid supporting document to this form before submitting. Once you have completed the appropriate section, please ensure that you sign and date this form at the bottom to authorize this change. Note:*= Mandatory Fields To submit this form please to HR Connect at hrconnectuk@estee-lauder.co.uk. For additional inquiries, please contact HR Employee Services at: Norway - Toll Free Phone: Toll Free Fax : Local Phone: Sweden - Toll Free Phone: Toll Free Fax : Local Phone: Denmark - Toll Free Phone: Toll Free Fax : Local Phone: A. *Employee Information *Employee Number: *Name: *Effective Date of this Change (DD-MM-YYYY): B. Update Name/Nationality/Marital Status First Name: Last Name: Previous Last Name: Preferred Name: Nationality: Marital Status: Separated Unknown Widowed Civil Partnership Legally Separated Unknown Living Together Single Divorced Domestic Partner Married (If Yes) Effective Date (DD-MM-YYYY): C. Update Contact Numbers and Please indicate if you are adding the contact information or removing this contact information Personal Add Address: D. *Contact Type: (Choose One Type) Home Phone Personal Mobile Secondary Work Phone Work Fax Work Mobile Other Number Add Remove Update Remove
2 E. Update Bank Account Information *Indicates Required Fields Account #1: Account Number: Account Name: Bank Name: Bank Code: IBAN Number: Short Code: Bank Registration Number: SWIFT: BIC: Monetary ( ) Amount OR Percentage ( ) Amount (Up to three decimal places) F. Change Address: Please Complete the Following: Address Line 1: Address Line 2: Address Line 3: City: Postal Code: Country: Other Address Information: **Please Select The Address Type For This Change: Primary Home Country Address Mailing Address (*If different from Primary Home Country Address) Secondary Address Address Line 1: Address Line 2: Address Line 3: City: Postal Code: Country: Other Address Information: **Please Select The Address Type For This Change: Primary Home Country Address Mailing Address (*If different from Primary Home Country Address) Secondary Address F. Update Emergency Contact or Dependents (If you need to add additional contacts, please use the lines below and then if necessary, attach another sheet to this form.) Please note: you must have at least one Emergency Contact on file at all times Number 1: Please check the Action you would like to take on this emergency contact Add New Edit Existing Remove *If removing, please indicate the name of the contact you would like to delete. Also, please provide your new emergency contact information. Name of Emergency Contact to be removed:
3 Add/Edit: *First Name: *Last Name: Relationship (Please Check One): Child *Emergency Contact Information 1: (Select an option) Work Number: Number 2:Please check the Action you would like to take on this emergency contact Add New Edit Existing Remove *If removing, please indicate the name of the contact you would like to delete. Also, please provide your new emergency contact information. Name of Emergency Contact to be removed: Add/Edit: *First Name: *Last Name: Relationship (Please Check One): Child *Emergency Contact Information 1: (Select an option) Work Number: Dependents? Yes No * If Yes, Enter Dependent #1 Full Name Relationship Type (i.e. Child): * Dependent Date of Birth (DD/MM/YYY): *Dependent #2 Full Name: *Dependent Date of Birth (DD/MM/YYY): *Relationship Type (i.e. Child): *Dependent#3 Full Name: *Dependent Date of Birth (DD/MM/YYY): *Relationship Type (i.e. Child): G. Employee Signature *Name: *Signature: * or Phone Number: *DD-MM-YYYY: Please send the completed form to the HR Connect at XXXXX@XXXXXXXX or Fax it to XXX-XXX-XXX
4 HR Connect Use Only Date Received (DD-MON-YYYY) : Date Completed (DD-MON-YYYY) : ESR Name: Signature: Audit Use Only: Auditor s Name: Issue: Date Audited (DD-MON-YYYY) : Date Corrected (DD-MON-YYYY) : Assigned To: Corrected By: Notified Participants Downstream: Remarks:
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