Name Change / Change In Marital Status - Byu Idaho

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Name Change / Change in Marital Status

Requirements:

You MUST submit this form with documentation supporting the change in name and/or marital status.

Marital status change submit one:

Birthdate change submit one:

Linking to spouse submit one:

Name changes submit one:



Marriage License

Driver’s License

Marriage License

Driver’s License



Temple Certificate

Birth Certificate

Temple Certificate

Divorce Decree



Divorce Decree

Passport

Social Security Card

Before BYU-Idaho can change your last name it MUST be changed with Social Security first. You can contact Social Security

Office for your name change at 1-800-772-1213 or 2196 Channing Way, Idaho Falls.

Reason for Change:

Marriage

Divorce

Correction

Other _____________________

What would you like us to do?

Marital Status Change

Change Name

Link to spouse

Birthdate

Female’s Information:

Are you a current or former BYU-I student or have you ever applied?

YES

______________________________

I-Number: _____________________________Social Security Number

(optional)*:

*Note: If you are a non-student spouse and would like to be eligible for services on campus (e.g. Hart Gym) please provide your S.S.#

Previous Name:

Last: ___________________________________First: ______________________________ Middle: ___________________________

Current Name:

Last: ____________________________________First: ______________________________ Middle: ___________________________

Date of Birth: ____________________

Note: Address and phone number can be updated online under profile.

Male’s Information:

re you a current or former BYU-I

student or have you ever applied?

YES

I-Number: _______________________________ Social Security Number

: ______________________________

(optional)

Note: If you are a non-student spouse and would like to be eligible for services on campus (e.g. Hart Gym) you must provide your S.S.#

Previous Name:

____________________________

________________________

_____________________

Last:

First:

Middle:

Current Name:

Last: ____________________________________First: ______________________________ Middle: ___________________________

Date of Birth: ____________________

Note: Address and phone number can be updated online under profile.

Signature(s):

I certify that no legal action has been undertaken by me in this state or in any other state in which I unsuccessfully attempted to change my

name/ marital status, and that this change of name/ marital status is not requested for the purpose of defrauding another or to avoid

creditors.

_______________________

Contact Phone #:

_______________________________________________

_________________

Female’s Signature

Date:

Male’s Signature

__________________

___________________________________________________________

Date:

Notes and Instructions

Office Use Only:

□

Note: If the name on your BYU-I Record does not match your social security card you will not be

Subscription:

Dean Notify:

issued a 1098-T form.

□

International students MUST counsel with International Services about name change before

Holds:

turning in this form.

Processed by: _______

If you are a BYU-I full-time employee, changes in name/marital status can be updated ONLY by

HR in KIM 226.

Processed Date: _________

Return form with the required documentation to BYU-Idaho, Student Records and Registration Office, KIM 190 Rexburg, ID 83460-1640; by FAX to (208) 496-

5003; by email to registrar@byui.edu

Updated: 4/21/2016