Personal Data Change Form US

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Amy Nicholson
5 years ago
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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.

Once you have completed the appropriate section, please ensure that you sign and date this form at the bottom to authorize this change.

1 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. For changing W-4 elections, please contact the Employee Services Center at Please provide supporting documentation for the following personal data changes: Personal Data Change Type Name Change Nationality Change Required Documentation Social Security Card*, passport, driver s license, marriage certificate, birth certificate, divorce decree, OR court ordered name change documents Passport, Birth Certificate, OR Naturalization certificate Direct Deposit Change Voided Check from the account the employee wishes to add/change. Forms missing a voided check will not be processed by Employee Services. To avoid receiving a live check, you must submit a void check with this form or you can log-in to Employee Self Service (ESS) to enter you direct deposit information. *If you cannot provide your SSN Card, please provide one of the other forms of documentation listed. For additional inquiries, please contact the HR Connect at or hrconnectus@estee.com Note:*= Mandatory Fields A. Employee Information* *Name: *Employee Number: *Effective Date of this Change (MM-DD-YYYY): B. Update Name/ Nationality (Please provide supporting documentation from the grid above together with this form) First Name: Middle Name: Last Name: Preferred Name: Previous Last Name: Nationality: C. Update Contact Numbers or Please indicate if you are adding this contact information or removing this contact information. Please be advised, that emergency alerts will only be text messaged to you if you select as your Contact Type If you would like to opt out of receiving emergency alert messages to your mobile device, please select: Yes No Tertiary Personal Fax

2 Tertiary Personal Fax Tertiary Personal Fax Personal Add Personal Add Remove Remove D. Update Bank Account Information (Please provide supporting voided check with this form) Please note: you may have up to two direct deposit accounts *Indicates required fields Account #1: *Add New Account Remove Existing account Update Existing Account *Please indicate if this account will be: Primary OR Secondary *Monetary Amount. OR Percentage Amount. (Up to three decimal places) OR please check here to deposit the remaining balance *If choosing remaining balance, please note that you must have one account on file. For 100% deposit into this account, please state 100% in the (Percentage) space. Account Name (Nickname): *Account Type: Checking Account OR Savings Account *Account Number: *Transit/Routing Code: Bank Name: Bank Branch: Account #2: *Add New Account Remove Existing account

3 *Please indicate if this account will be: Primary OR Secondary *Monetary Amount. OR Percentage Amount. (Up to three decimal places) OR please check here to deposit the remaining balance *If choosing remaining balance, please note that you must have one account on file. For 100% deposit into this account, please state 100% in the (Percentage) space. Account Name (Nickname): *Account Type: Checking Account OR Savings Account *Account Number: *Transit/Routing Code: Bank Name: Bank Branch: E. Change Address Please complete the following : *Address Line 1 : Address Line 2 : Address Line 3 : *City / State *Postal Code: Country: County: *Please select the address type for this change: Mailing Address *If different from Primary Country Address Primary Country Address *Used for Taxation purposes. Must be US residence. Secondary Address (Please use the lines below only if you want to fill in another address) *Address Line 1: Address Line 2: Address Line 3: *City / State *Postal Code: Country: County:

4 *Please select the following address type for this change: Mailing Address Primary Country Address Equity Secondary Address Global Address Registered Address F. Update Emergency Contact Please note: you must have at least one Emergency Contact on file at all times 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 *First Name: Middle Name: *Last Name: Suffix: Adopted Child Aunt Brother Child Contact Disabled Child Domestic Partner Domestic Partner Child Emergency Father Foster Child Relative Sister Step Child Uncle Nephew Next of Kin Niece Parent Recognized Natural Child Friend Spouse Mother * 1 st Contact Type: (Choose One) Son Tertiary Personal Fax * 2 nd Contact Type (if available): (Choose One) Tertiary Personal Fax Please check if you would like this contact to be your primary (1st contacted) emergency contact

5 G. Update Payslip Preference (You are automatically default to Yes/ Yes in the system) *Online Payslips: Yes No *Paper Payslips: Yes No Employee Signature* *Name: *Signature: * or Phone Number: *Date: Please send the completed form to the HR Connect at or Fax it to HR Connect Use Only Date Received (MM-DD-YYYY): ESR Name: Date Completed (MM-DD-YYYY): Signature: Remarks: Audit Use Only: Auditor s Name: Date Audited (MM-DD-YYYY): Issue: Date Corrected (MM-DD-YYYY): Assigned To: Corrected By: Notified Participants Downstream:

Personal Data Change Form - Nordic

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