Martinsville Employee Change Of Address Form

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OFFICE OF HUMAN RESOURCES
Employee Change of Address Form
Name _________________________________________________
New Address ___________________________________________
_______________________________________________________
_______________________________________________________
Telephone Number ( )____________________________________
Effective Date ___________________________________________
Signature _______________________________________________
(Please complete form and return to: City of Martinsville Human Resources, PO Box 1112, Martinsville, VA 24114)

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